Department of Communication, Fairfax, VA, USA.
Patient Educ Couns. 2011 Jun;83(3):375-81. doi: 10.1016/j.pec.2011.04.029. Epub 2011 May 24.
Poor adherence with prescription medications is a serious problem in health care, especially true for patients with chronic diseases. Previous strategies to promote adherence have generally not resulted in long-term improvements. This research program is designed to improve on past intervention strategies by developing evidence-based and theoretically grounded communication interventions to promote increased adherence.
Phase 1 of this research program used qualitative methods to examine the uncertainties and concerns that influence medication adherence, identify messages for addressing these concerns, and develop refined motivational messages for promoting medication adherence. Phase 2 of this research program experimentally assessed chronic disease patients' evaluations of the refined motivational messages.
Phase 1 qualitative research indicated that patient concerns about their need for the prescribed medication (commitment) was the primary adherence issue, followed by concerns about side effects and the safety of prescription medications, and concerns about the medication costs. These three key issues were translated into draft motivational messages which were evaluated, validated, and refined. Phase 2 experimental research showed that exposure to motivational messages increased consumers' intention to adhere with medication recommendations.
Follow-up intervention research is warranted to test the use of these motivational messages to promote medication adherence.
Pharmacies and pharmacists have the potential to perform a central role in providing consumers with the relevant information they need to make responsible decisions that lead to increased adherence with prescription medication recommendations.
在医疗保健中，患者对处方药物的依从性差是一个严重的问题，尤其是慢性病患者。以往促进依从性的策略通常并未导致长期改善。本研究计划旨在通过开发基于证据和理论的沟通干预措施来提高依从性，从而改进过去的干预策略。
该研究计划的第 1 阶段采用定性方法，研究影响药物依从性的不确定性和关注点，确定针对这些问题的信息，并制定促进药物依从性的改进型激励信息。该研究计划的第 2 阶段则通过实验评估了慢性病患者对改进型激励信息的评价。
第 1 阶段的定性研究表明，患者对其所需处方药物的关注（承诺）是主要的依从性问题，其次是对副作用、处方药安全性以及药物费用的关注。这三个关键问题被转化为草稿激励信息，然后对其进行评估、验证和完善。第 2 阶段的实验研究表明，接触激励信息会增加消费者遵从药物推荐的意愿。
有必要进行后续干预研究，以检验这些激励信息在促进药物依从性方面的应用。
药店和药剂师有可能在为消费者提供做出负责任决策所需的相关信息方面发挥核心作用，从而提高对处方药推荐的依从性。
