ARTICLES

Non-adherence is a major issue that can be addressed by PSPs Non-adherence impedes patients from benefiting from the clinical promise of their treatment. Medications that have proven their potential in clinical trials may not deliver on that potential in the real world, potentially because of non-adherence.1 The numbers speak for themselves: average adherence rates for…

Patient Support Programs are behavioral interventions for improving adherence Non-adherence to therapies in neurological conditions is a significant issue, associated with worse clinical outcomes and increased healthcare utilization and costs.1 There are many factors involved, including complexity of medication regimens, depression, gender, and duration of disease that may lead to a patient being non-adherent,2,3 therefore,…

As described in the previous articles, adherence to treatment of patients suffering from neurological conditions can be a big issue; for Parkinson’s disease, sub-optimal adherence is estimated to vary between 10 and 67%,1 and up to half of patients with conditions such as epilepsy and bipolar disorder are estimated to be non-adherent to medication.2,3 Low…

Measures and survey tools are useful for characterizing patient health behavior Chronic diseases are a global public health issue and are increasing in prevalence and associated costs. These conditions require significant self-management by patients, including adherence to therapy regimens and medication.1 Adherence to epilepsy medication is associated with improved control of symptoms; however, non-adherence is…

Improving patient outcomes and adherence requires an actionable framework Previous articles in this series demonstrate that non-adherence is a significant public health issue in patients with neurologic disease. A study conducted in Europe in 2004 estimated that the annual economic cost of neurological disease (including dementia, epilepsy, migraine and other headaches, multiple sclerosis, Parkinson’s disease…

The Transtheoretical Model: a tool for influencing positive behavioral change Neurological disorders are a significant public health issue worldwide.1 Non-adherence to therapy for these conditions results in poor response to therapy, impacts on the quality of life of patients and causes associated costs to them and healthcare systems.2,3 Non-adherence rates have been shown to be…

How do people make difficult decisions? How do people decide which career to undertake, what car to buy, or whether to take medication? Important decisions are typically the result of some degree of thought and planning, a process that Daniel Kahneman labelled “System 2” thinking in his groundbreaking book, Thinking Fast and Slow.1 What is…

The Health Belief Model (HBM) is a model to help understand what patients believe about their health The HBM can be used to identify detrimental patient behaviors caused by a poor understanding of a condition or treatment The HBM can be used to structure interactions with patients to enhance their understanding of treatment and lifestyle…

As described in the articles, Two systems of thought: Why “rational” people make “irrational” choices,  the mind has two systems of thinking: System 1 and System 2. System 1 is immediate and spontaneous; System 2 is reflective and conscious but requires cognitive effort and is used less frequently. System 1, governing our immediate, impulsive reaction,…

Recent breakthroughs in behavioral science demonstrate that people make decisions, including treatment adherence decisions, according to two systems of thinking: System 1, which is rapid but intuitive and biased, and System 2, which is more rational and reflective but complex.  Humans tend to favor System 1.  Both System 1 and System 2 lead to intentional…

Non-adherence factors may be organized into five categories: socioeconomic, health care team and system-related, disease-related, therapy-related, and patient-related. Behavioral drivers of non-adherence are both intentional and unintentional. Despite extensive research, no single model has yet been shown to be highly accurate in predicting patient adherence. Treatment adherence offers a significant opportunity for improved outcomes Characterizing…

Increasing adherence to therapy represents a significant opportunity area for improving outcomes. Increased adherence can improve the clinical outcomes and quality of life of patients with neurological disorders.1,2 Patients with Parkinson’s disease have higher medical-care needs, often miss work and require care; these effects contribute to the overall economic burden.3 Patients with uncontrolled epileptic seizures…

Neurological disorders are a growing burden for healthcare systems worldwide.  Neurological disorders contributed to 5–10% of the global burden of disease in 2005 (assessed in disability-adjusted life years).1 Conditions such as Parkinson’s disease and epilepsy have significant associated costs and reduced quality of life for patients.2,3 Treatment of these chronic diseases requires patients to incorporate…