Adherence: a concept analysis

Bissonnette, Janice

doi:10.1111/j.1365-2648.2008.04745.x

Cited by 123 publications

(97 citation statements)

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“…'compliance' , 'adherence' , 'persistence' , and 'concordance' , are used to define different aspects of the act of seeking medical attention, acquiring prescriptions and taking medicines appropriately [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. These terms are often used interchangeably, but they impose different views about the relationship between the patient and the health care professional [38][39][40].…”

Section: Introductionmentioning

confidence: 99%

A New Taxonomy for Describing and Defining Adherence to Medications

Vrijens

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Hughes

et al. 2011

British Journal of Clinical Pharmacology

230

316

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Interest in patient adherence has increased in recent years, with a growing literature that shows the pervasiveness of poor adherence to appropriately prescribed medications. However, four decades of adherence research has not resulted in uniformity in the terminology used to describe deviations from prescribed therapies. The aim of this review was to propose a new taxonomy, in which adherence to medications is conceptualized, based on behavioural and pharmacological science, and which will support quantifiable parameters. A systematic literature review was performed using MEDLINE, EMBASE, CINAHL, the Cochrane Library and PsycINFO from database inception to 1 April 2009. The objective was to identify the different conceptual approaches to adherence research. Definitions were analyzed according to time and methodological perspectives. A taxonomic approach was subsequently derived, evaluated and discussed with international experts. More than 10 different terms describing medication-taking behaviour were identified through the literature review, often with differing meanings. The conceptual foundation for a new, transparent taxonomy relies on three elements, which make a clear distinction between processes that describe actions through established routines ('Adherence to medications' , 'Management of adherence') and the discipline that studies those processes ('Adherence-related sciences'). 'Adherence to medications' is the process by which patients take their medication as prescribed, further divided into three quantifiable phases: 'Initiation' , 'Implementation' and 'Discontinuation' . In response to the proliferation of ambiguous or unquantifiable terms in the literature on medication adherence, this research has resulted in a new conceptual foundation for a transparent taxonomy. The terms and definitions are focused on promoting consistency and quantification in terminology and methods to aid in the conduct, analysis and interpretation of scientific studies of medication adherence.

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Section: Introductionmentioning

confidence: 99%

A New Taxonomy for Describing and Defining Adherence to Medications

Vrijens

Geest

Hughes

et al. 2011

British Journal of Clinical Pharmacology

230

316

View full text Add to dashboard Cite

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“…Also of great concern is the declining adherence: the extent to which patients follow the instructions they are given for prescribed treatments (Bissonnette, 2008) allostatic load: physiological consequences of chronic exposure to fluctuating or heightened neural or neuroendocrine response that results from repeated or chronic stress…”

Section: Resultsmentioning

confidence: 99%

“…The term concordance is becoming more prevalent in literature, and perhaps is theoretically different than adherence in that it is an attempt to equalize the power balance between healthcare professionals and patients, while at the same time placing patients ' expectations about treatment recommendations as equal to or even more important than 16 healthcare professional ' s expectations (Bissonnette, 2008). Concordance more accurately describes interactions in which the expertise of patients and health care professionals can be pooled to arrive at mutually agreed upon goals (Bissell, May & Noyce;.…”

mentioning

confidence: 99%

“…In pharmacology literature, the term adherence has been recognized as more appropriate than compliance to reflect the partnership between the health care provider and the patient (Tilson, 2004). A concept analysis of adherence by Bissonnette (2008) found through review of literature from pharmacy, mental health, medicine and nursing that there was no distinct differentiation between adherence and compliance. From the concept anal ysis, the accepted definition for adherence was "the extent to which patients follow the instructions they are given for prescribed treatments" .…”

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confidence: 99%

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Adherence to physical activity for adults with depression: the role of the nurse practitioner - an integrative literature review

Hogan¹

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Depression is a significant problem for Canadians, as is the declining overall health of adults due to sedentary lifestyles. The purpose of this integrative literature review is to examine how nurse practitioners, providing primary health care in Canada, can facilitate adherence to physical activity for adults with mild to moderate depression. Background knowledge of depression, physical activity and adherence is presented along with an overview of primary health care. A Medline search collected 15 research articles for analysis. Key findings included reduced adherence to exercise for adults with depression, positive effects on mood from moderate intensity exercise, health promotion challenges within primary care, and interdisciplinary approaches to improving adherence. Recommendations are presented using the SA's approach and include the application of psychological theories, assessment of readiness for exercise, individualized exercise prescription targeting public health guidelines, enlisting social supports, frequent follow-up, along with additional education to practitioners.

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“…Furthermore, information needs can differ in various patient groups, according to gender, age and type of disease (110). Appropriate information and a better understanding of the individual's needs and concerns should be considered potential components for improving patient-related outcomes, such as adherence to advice and treatment, quality of life, or stress (111).…”

Section: The Importance Of Disease Related Knowledgementioning

confidence: 99%

Life situation among persons living with inflammatory bowel disease.

Lesnovska¹

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Living with inflammatory bowel disease (IBD) affects physical, psychological and social dimensions, limiting the ability to engage in daily activities. Persons with IBD may need frequent and lifelong contacts with the healthcare (HC), highlighting the importance of quality care. High quality HC for persons with IBD involves a partnership between the HC professionals and the person living with the disease. Information is essential, the more a person knows about their disease, the more concordant and satisfied with their treatment they are likely to be. The overall aim of this thesis was to describe the knowledge need, life situation and perception of HC among persons living with IBD, in order to develop a questionnaire to evaluate the quality of HC. This thesis is based on three studies that are presented in four papers. Qualitative methods were used to describe aspects of life situation in relation to the disease, whereas quantitative method was used to develop a questionnaire measuring quality of care. Study I and II have an inductive qualitative design. In study I, qualitative interviews with 30 people were performed to describe the knowledge need and experience of critical incidents in daily life while living with IBD. The interviews in study I were analyzed using content analysis (results presented in Paper I) and critical incident technique (results presented in Paper II). In study II, the perceptions of HC among persons living with IBD was explored in five focus group interviews and two individual interviews, in total n=26. Study III aimed to develop and evaluate a questionnaire, measuring quality of care among persons with IBD, including 318 persons with IBD and 8 professionals. The knowledge need among persons with IBD focused on managing symptoms and course of the disease and learning to assimilate the information in order to manage everyday life. Losing bowel control was of great concern for most of the informants in the study. Many of the informants said that “the bowel ruled their life” and that it influenced them to a great extent in their daily lives. The perception of HC among persons with IBD meant being met with respect and mutual trust, receiving information at the right time, shared decision-making, competence and communication, access to care, accommodation, continuity of care and the pros and cons of specialized care. The quality of care questionnaire QoC-IBD was constructed in five dimensions, building on the results from Study I and II. The dimensions were trust and respect, decision-making, information, continuity of care and access to care consisting of 21 questions in total. QoC-IBD is a short, self-administrated questionnaire that measures experiences of healthcare among persons with IBD with promising validity and reliability. To improve quality of care, HC is recommended to consider individual care needs and take the person’s daily life and social context into account. The QoC-IBD questionnaire measures the subjective experience of quality of care. Further testing in clinical practice...

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Adherence: a concept analysis

Abstract: This concept analysis of adherence is a preliminary step towards broadening nurses' appreciation of the complexity of patient adherence behaviour.

Cited by 123 publications

References 61 publications

A New Taxonomy for Describing and Defining Adherence to Medications

A New Taxonomy for Describing and Defining Adherence to Medications

Adherence to physical activity for adults with depression: the role of the nurse practitioner - an integrative literature review

Life situation among persons living with inflammatory bowel disease.

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