A Quantitative Framework for Medication Non-Adherence: Integrating Patient Treatment Expectations and Preferences.

dc.contributor.author

Muiruri, Charles

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van den Broek-Altenburg, Eline M

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Bosworth, Hayden B

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Cené, Crystal W

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Gonzalez, Juan Marcos

dc.date.accessioned

2024-01-01T16:43:47Z

dc.date.available

2024-01-01T16:43:47Z

dc.date.issued

2023-01

dc.description.abstract

Introduction

Medication non-adherence remains a significant challenge in healthcare, impacting treatment outcomes and the overall effectiveness of medical interventions. This article introduces a novel approach to understanding and predicting medication non-adherence by integrating patient beliefs, efficacy expectations, and perceived costs. Existing theoretical models often fall short in quantifying the impact of barrier removal on medication adherence and struggle to address cases where patients consciously choose not to follow prescribed medication regimens. In response to these limitations, this study presents an empirical framework that seeks to provide a quantifiable model for both individual and population-level prediction of non-adherence under different scenarios.

Methods

We present an empirical framework that includes a health production function, specifically applied to antihypertensive medications nonadherence. Data collection involved a pilot study that utilized a double-bound contingent-belief (DBCB) questionnaire. Through this questionnaire, participants could express how efficacy and side effects were affected by controlled levels of non-adherence, allowing for the estimation of sensitivity in health outcomes and costs.

Results

Parameters derived from the DBCB questionnaire revealed that on average, patients with hypertension anticipated that treatment efficacy was less sensitive to non-adherence than side effects. Our derived health production function suggests that patients may strategically manage adherence to minimize side effects, without compromising efficacy. Patients' inclination to manage medication intake is closely linked to the relative importance they assign to treatment efficacy and side effects. Model outcomes indicate that patients opt for full adherence when efficacy outweighs side effects. Our findings also indicated an association between income and patient expectations regarding the health of antihypertensive medications.

Conclusion

Our framework represents a pioneering effort to quantitatively link non-adherence to patient preferences. Preliminary results from our pilot study of patients with hypertension suggest that the framework offers a viable alternative for evaluating the potential impact of interventions on treatment adherence.
dc.identifier

434640

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1177-889X

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1177-889X

dc.identifier.uri

https://hdl.handle.net/10161/29587

dc.language

eng

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Informa UK Limited

dc.relation.ispartof

Patient preference and adherence

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10.2147/ppa.s434640

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

behavioral model

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health production

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medication adherence

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patient preferences

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quantitative framework

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side effects

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treatment efficacy

dc.title

A Quantitative Framework for Medication Non-Adherence: Integrating Patient Treatment Expectations and Preferences.

dc.type

Journal article

duke.contributor.orcid

Muiruri, Charles|0000-0003-0213-0362

duke.contributor.orcid

Bosworth, Hayden B|0000-0001-6188-9825

duke.contributor.orcid

Gonzalez, Juan Marcos|0000-0002-5386-0907

pubs.begin-page

3135

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3145

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Duke

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School of Medicine

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Staff

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Medicine

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Psychiatry & Behavioral Sciences

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Medicine, General Internal Medicine

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Duke Cancer Institute

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Duke Clinical Research Institute

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Institutes and Provost's Academic Units

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University Institutes and Centers

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Duke Global Health Institute

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Center for the Study of Aging and Human Development

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Initiatives

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Duke Science & Society

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Population Health Sciences

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Duke Innovation & Entrepreneurship

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Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences

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Duke - Margolis Center For Health Policy

pubs.publication-status

Published

pubs.volume

17

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