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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 28-29, 2009 Dissemination and Implementation Conference
February 9, 2009, 10:00 – 11:00 AM
Stigma: Lessons & New Directions from a Decade of Research on Mental Illness
July 12-24, 2009
OBSSR/NIH Summer Training Institute on Randomized Clinical Trials Involving Behavioral Interventions
May 3-8, 2009
Institute on Systems Science and Health
May 22-25, 2009
Gene-Environment Interplay in Stress and Health at the Association for Psychological Science 21st Annual Convention, San Francisco, CA
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Home > Scientific Areas > Health Behavior > Adherence
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Adherence |
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Several recent reports and literature reviews point to the continued need for improved 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, often 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. This, of course, presumes that 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 that trickle up to society as a whole.
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 have begun to explore potential mechanisms that 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.
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.
NIH currently has a number of active funding opportunity announcements (FOA) appropriate for those seeking support for adherence research. The following link provides a listing of such opportunities.
http://grants.nih.gov/
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. These documents provide comprehensive reviews of the topic.
Enhancing Prescription Medicine Adherence: A National Action Plan, August 2007
National Council on Patient Information and Education. Washington, DC.
Adherence to Long-term Therapies: Evidence for Action, 2003
World Health Organization, ISBN 92 4 154599 2
Interventions for enhancing medication adherence, January 2000
Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X, Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD000011. DOI: 10.1002/14651858.CD000011.pub3
Effectiveness of interventions to improve patient compliance: a meta-analysis, August 1998
D. L. Roter, J. A. Hall, R. Merisca, B. Nordstrom, D. Cretin, and B. Svarstad, Medical Care, 36, 8, 1998, pp. 1138-1161
The multilevel compliance challenge: recommendations for a call to action. A statement for healthcare professionals, February 1997,
American Heart Association, Circulation, 1997; 95:1085-1090.
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