Improving Treatment Regimen Adherence in Coronary Heart Disease by Targeting Patient Types
Patient adherence to a treatment plan is central to the control of coronary heart disease (CHD) and in the prevention of complications; it is reported to be the single most important challenge in the management of CHD and related conditions. The following article provides an overview of adherence in CHD, with particular emphasis on two important theories of behavior change: the ‘Health Belief Model’ and the ‘Transtheoretical Model’. Three types of individuals are discussed in relation to these theories: (i) patients who are non-adherent (5–10% of the CHD population); (ii) patients who are partially adherent (30–40% of the CHD population); and (iii) patients who are near-optimally adherent (50–60% of the CHD population). Adherence predictor strategies and recommended interventions for each of these groups are provided in table format. Disease management tools and resources that assist in targeting interventions to the unique adherence needs of these three very different groups are also listed. It was our conclusion that regardless of the interventions that are utilized in CHD management programs, understanding the differences between partially adherent, non-adherent, and near-optimally adherent patients, and targeting interventions to these groups, can optimize the impact of CHD interventions.
KeywordsCoronary Heart Disease Patient Adherence Health Belief Model Transtheoretical Model Adherent Patient
The authors gratefully acknowledge Beth Bridges, Steve Teutsch, Camelot Ives, Douglas Jordan, and Thomas McCready for their assistance with this project, and Marc Berger and Peter Nebenfuhr for their continued support of this initiative. No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review. The authors are employees and stockholders of Merck & Co., Inc.
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