Further Challenges in Adherence Research: Measurements, Methodologies, and Mental Health Care

摘要

The health outcomes of patients with chronic diseases depend heavily on their adherence to appropriate treatment recommendations. Patient nonadherence is a pervasive problem, which leads to missed opportunities to prevent the onset and progression of chronic conditions and which frustrates physicians and confuses the clinical picture. Adherence requires that patients understand, accept, and follow through with many types of regimens; and as the article by Cantrell et al in this issue of Medical Care demonstrates, nonadherence in the context of mental health treatment, particularly antidepressant therapy, is very common. In this study, fewer than 50% of patients adhered to their recommended medication regimens. This article reminds us to consider some of the most critically important questions in the field of adherence research today: 1) How are findings influenced by measurement strategies? 2) What are the costs and consequences of nonadherence in terms of money, health, and well-being? 3) What substantive issues are relevant in nonadherence to mental health treatments? These questions stand as guideposts in exploring some key challenges in the future of adherence research.