ENHANCING MEDICATION ADHERENCE THROUGH COMMUNICATION AND INFORMED COLLABORATIVE CHOICE

The failure of patients to adhere to medication is a significant problem in clinical medicine. In simple short-term acute care, as well as in complex longer term treatment for chronic illness, the medical prescription is ignored or followed incorrectly more than 40% of the time. Recent research on adherence points to the critical role played by a patient's knowledge and beliefs about the benefits (vs. costs and risks) and efficacy of adhering, as well as by his or her ability to overcome some practical social barriers. Long-term and particularly lifetime regimens require commitment and independent action on the part of the patient. PREPARED(R) is a system that has recently been developed to standardize and categorize information about benefits versus costs and risks of treatment. In this system, providers and patients each bring their own expertise to bear on health care decisions. Communication of understandable information about the benefits versus costs of medication and of unambiguous details of the regimen (e.g., timing of doses) is facilitated. Research is reviewed that stresses the importance of a collaborative relationship between provider and patient both when the regimen is chosen and throughout its implementation. The role of the PREPARED system in enhancing informed collaborative choice is discussed in light of research on patient adherence to medication treatment.