Facilitating Treatment Adherence: A Practitioner's Guidebook

Prologue.- 1 The Nature of Adherence.- 1 Treatment Adherence: Terminology, Incidence, and Conceptualization.- Incidence of Nonadherence.- Assessment of Adherence.- Self-Report.- Behavioral Measures.- Biochemical Measures.- Clinical Outcome.- A Cautionary Note for Health Care Providers.- 2 Factors Affecting Adherence.- Patient Variables.- Role of the Patient's Beliefs.- Treatment Variables.- Complexity of the Therapeutic Regimen.- Intrusiveness.- Duration of Treatment.- Knowledge of Illness.- Illness and Symptom Variables.- Relationship Variables.- Organizational-Structural Variables.- II Adherence Enhancement Procedures.- 3 Enhancing the Relationship between the Patient and the Health Care Provider.- The Changing Relationship.- Behavior That Interferes with Communication and the Development of Relationship.- Facilitating the Communication Process.- Cultivating Communication Skills.- Patients' Explanatory Model of Their Illness.- Patients' Worries and Concerns about Illness.- Patient Expectations about Treatment.- 4 Patient Education: Organizing and Structuring.- Providing Patients with Information.- Treating an Acute Disorder by Means of Medication.- Treating a Chronic Disorder by Means of Medication.- Simplifying and Customizing the Treatment Regimen.- Reducing Patient Forgetfulness.- Discussing Possible Side Effects.- 5 Behavior Modification Approaches.- Some Basic Concepts.- Self-Monitoring.- Soliciting Patients' Suggestions and Preferences.- Goal Setting.- Corrective Feedback.- Behavioral Contracting.- Commitment Enhancement Procedures.- Reinforcement Procedures.- 6 Teaching Self-Regulatory Skills.- Establishing a Collaborative Relationship.- Skills Training.- Problem-Solving Skills.- Intrapersonal and Interpersonal Skills.- Coping and Benefiting from Lapses.- Attribution Retraining.- 7 Additional Interventions.- Emotional Inducements.- Emotional Role Playing.- Social Support.- Adherence Counseling.- Psychotherapeutic Interventions.- Paradoxical Interventions.- Another Level of Intervention.- III Integration of Adherence Procedures and Impediments to Their Use.- 8 The Integrated Application of Adherence Enhancement Interventions.- Examples of Integrative Adherence Programs.- Guideline 1: Anticipate Nonadherence.- Guideline 2: Consider the Prescribed Self-Care Regimen from the Patient's Perspective.- Guideline 3: Foster a Collaborative Relationship Based on Negotiation.- Guideline 4: Be Patient-Oriented.- Guideline 5: Customize Treatment.- Guideline 6: Enlist Family Support.- Guideline 7: Provide a System of Continuity and Accessibility.- Guideline 8: Make Use of Other Health Care Providers and Personnel as Well as Community Resources.- Guideline 9: Repeat Everything.- Guideline 10: Don't Give Up!.- 9 Why Health Care Providers Will Not Adhere to the Recommendations Outlined in This Volume (or Perhaps They Will).- Impediments to HCP Adherence.- The Beliefs of HCPs.- Low Expectation That Adherence Procedures Will Work.- Memory.- Inertia.- Epilogue.- References.- Author Index.