RIVERSIDE, Calif. – Physicians can help their patients follow prescribed treatments and achieve healthier results – particularly in chronic disease management – by using a three-pronged strategy developed by a team of researchers from the University of California, Riverside, Texas State University-San Marcos, and La Sierra University in Riverside, Calif.
The Information-Motivation-Strategy (IMS) Model – developed after synthesizing findings from more than 100 large-scale studies and meta-analyses conducted between 1948 and 2009 – appears in the peer-reviewed journal Health Psychology Review .
Nonadherence costs the U.S. health care system between $290 billion and $300 billion annually and wastes an estimated 275 million medical visits every year, according to study authors Robin DiMatteo of UC Riverside, Kelly Haskard-Zolnierek of Texas State University and Leslie Martin of La Sierra University. Haskard-Zolnierek and Martin earned their Ph.D.s in psychology at UC Riverside.
The World Health Organization estimates that in developed countries half of patients with chronic disease do not adhere to prescribed medication regimens; the number is far worse in developing countries.
"When regimens are more complex and intrusive patients are more prone to forget what they are supposed to do and are less likely to be able to carry out the directives that they do recall. Patients carry out prescribed regimens less effectively when they view their health problem as less severe," the authors wrote in their paper, "Improving Patient Adherence: A Three-factor Model to Guide Practice."
Nonadherence often is unrecognized by patients and their clinicians, according to DiMatteo, the study's lead author. "Patients often misunderstand the value of following medical recommendations accurately and physicians often overestimate patient adherence or cannot determine which patients are having adherence difficulties."
The model identifies three categories to guide providers and patients toward adherence: Information, Motivation and Strategy.
The IMS Model emphasizes the importance of patient-practitioner relationships for effectively informing, motivating and strategizing with patients. It also is a useful tool for targeting patient needs, focusing on elements that are essential to achieving individual patient adherence ,and ultimately optimizing health outcomes, the researchers wrote.
"Nonadherence is a complex problem and addressing it requires the efforts of both patients and clinicians, as well as all members of the health care team and the individuals who are part of patients' everyday lives," they said.
Health Psychology Review