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December 12, 2008
Retreat Refreshes Behavioral, Social Sciences
Dr. Christine Bachrach
Dr. Christine Bachrach, acting director of the Office of Behavioral and Social Sciences Research, wanted just one thing out of the first-ever day-long retreat for NIH’s widely dispersed community of behavioral and social scientists, held Nov. 12 at Natcher Bldg.
December 12, 2008
CBT4CBT
New Hope for Treatment of Addiction
Dr. Kathleen Carroll
Drug addiction is notoriously tough to treat, but now research is showing a fresh way to tackle the problem. It’s called computer-based training for cognitive-behavioral therapy (CBT4CBT)
OBSSR’s Mabry Wins with Systems Analysis Team
OBSSR’s Mabry Wins with Systems Analysis Team
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January 22, 2009, 3:00 PM to 4:00 PM
Sex, Drugs, and Viral Load: Integrating HIV/AIDS Prevention and Treatment
January 28-29, 2009 Dissemination and Implementation Conference
Reminder — PLEASE DISTRIBUTE
July 12-24, 2009
OBSSR/NIH Summer Training Institute on Randomized Clinical Trials Involving Behavioral Interventions
APPLICATIONS DUE Midnight on Sunday, January 4, 2009
Click Here
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Home > Scientific Areas > Health Behavior > Adherence
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Adherence |
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Background
Several recent reports and literature reviews point to the continuing need for improving adherence to therapeutic regimens. Adherence rates vary considerably across diseases and treatments, measuring instruments, and populations, with rates ranging from 30% to 60% in many instances. Most researchers agree that at least 50% of persons for whom drugs are prescribed fail to receive the full benefit through inadequate adherence. As noted by the American Heart Association (1997), the rationale for enhancing [adherence] is based on the premise that the patient will get well or stay well if the physician, other healthcare providers, and the healthcare organization make appropriate recommendations, providing the patient has the requisite knowledge, motivation, skills, and resources to follow the recommendations. Lack of adherence to therapeutic regimens may result in poorer health for individuals as well as economic costs for their health-care organizations and the broader society
Health-care providers, organizational systems, and personal factors all play a role in adherence to therapeutic regimens. Thus, to understand and eventually improve adherence, conceptual frameworks and interventions need to take into account institutional, system, situational, interpersonal, and personal factors as well as the characteristics of the illness or condition and of the treatment regimen.
Much of the current adherence research focuses on one disease and a single kind of provider. Little work has been done to consolidate findings, such that adherence interventions may be used in a variety of settings, by a full spectrum of clinicians, for many diseases. The limited number of interventions shown to improve adherence have been multifaceted, complex and often expensive. The behavioral and social sciences must provide the core strategies for improved adherence.
OBSSR along with a network of professionals within NIH, The Adherence Research Network, is working to encourage research and ascertain how best NIH can disseminate information on proven methods for improved adherence.
Finding Adherence Research
OBSSR recently began to evaluate NIH’s research portfolio of Adherence research. The purpose of this evaluation is to ascertain gaps in the research and next steps. Initial findings from this evaluation suggest that those interested in this topic explore the NIH CRISP database to identify existing funded research. In order to optimize the search strategy, we recommend that the CRISP term Therapy Compliance be used rather than the term Adherence.
References (listed chronologically)
A search of Medline reveals thousands of articles on the topic of adherence and compliance, so we clearly will not include those here. However, we have listed some summary reports that act as a baseline for current issues in adherence. As these documents were produced outside of NIH, the NIH cannot endorse the conclusions or recommendations. We simply provide these as documents that provide comprehensive reviews of the topic.
Interventions for enhancing medication adherence (Review)
The Cochrane Collaboration. John Wiley & Sons, Ltd, 2008
Enhancing Prescription Medicine Adherence: A National Action Plan
National Council on Patient Information and Education. Washington, DC. August 2007
Adherence to Long-term Therapies: Evidence for Action. World Health Organization, 2003
American Heart Association, The Multilevel Compliance Challenge: Recommendations for a Call to Action,
Circulation, 1997; 95:1085-1090.
D. L. Roter, J. A. Hall, R. Merisca, B. Nordstrom, D. Cretin, and B. Svarstad, Effectiveness of interventions to
Improve patient compliance, Medical Care, 36, 8, 1998, pp. 1138-1161
Adherence Research Network Products
Framework for Adherence Research and Translation: A Blueprint for the Next Ten Years
On March 19, 2008, the Office of Behavioral and Social Sciences Research and the National Institute of Mental Health sponsored a full day workshop on the topic of adherence research. Participants discussed research activities focused on improvement in adherence, evaluation of the impact (or lack thereof) and consolidation of research results. A major focus of this discussion was the challenges and need for translation of research findings into a variety of settings. The workshop took full advantage of multiple breakout sessions.
Assessing the Needs for a Trans-NIH Agenda for Adherence Research: A Feasibility Study
The National Institutes of Health (NIH) Office of Behavioral and Social Sciences Research (OBSSR) contracted with the RAND Corporation to conduct a study to lay the groundwork for developing measures and methods for reporting on the results of NIH-wide efforts to promote research on patient adherence to preventive or therapeutic regimens recommended by a healthcare provider. The study had two major objectives: (1) describe NIH investments in adherence-related research based on our recommended approaches; and (2) summarize our experiences and recommendations for a future NIH evaluation of investments in adherence-related research projects. An additional objective (3) was to illustrate the types of questions that can be conducted to shed light on ways NIH might be able to encourage greater investments in therapy compliance (TC) research projects using funding opportunity announcements (FOAs). The data and methods identified and developed for this project provide a unique opportunity to empirically explore this issue.
Funding Opportunity Announcements
The link below will generate a list of currently active funding opportunity announcements at the NIH.
http://grants.nih.gov/
Upcoming Conferences
HIV Treatment Adherence, to be held April 5-7 2009 in Miami Florida.
http://www.iapac.org/AdherenceConference/AdherenceConf2009-info.html
NIH Staff for Advice and Questions
Program staff from most of the NIH Institutes, Offices, and Centers are members of the NIH Adherence Research Network. They stand ready to offer advice to potential grant applicants concerning funding opportunities at their organizations and about conducting research on adherence.
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