With healthcare policies shifting from fee-for-service to performance-based payment models that hold providers accountable for poor outcomes, a better understanding of factors that contribute to non-adherence and effective strategies for improvement are needed. This course covers the wide array of contributing forces behind non-adherence, along with evidence-based interventions for optimizing outcomes. You will also learn how to apply interventions best suited to individual patients based on their needs and risks related to adherence.
Section 1: Introduction A. About This Course B. Learning Objectives Section 2: Definitions, Prevalence, and Consequences A. Meet Judy B. Definitions C. Non-Adherent Behavior D. Prevalence of Non-Adherence E. Consequences of Non-Adherence F. Review G. Summary Section 3: Factors Influencing Adherence A. The 5 Dimensions of Therapeutic Adherence B. Social and Economic Factors C. Health Literacy and English Proficiency D. Social Support E. Financial Resources F. Therapy-Related Factors G. Complexity of Regimen H. Perceived Efficacy I. Patient-Related Factors J. Physical Aspects K. Psychological Aspects L. Condition-Related Factors M. Severity of Disease N. Asymptomatic Conditions O. Chronic Conditions P. Health System/Provider-Related Factors Q. Payment Structure and Appointments Too Short R. Long Wait Times and Inconvenient Scheduling S. Provider-Patient Relationship and Communication T. Review U. Summary Section 4: Adherence Interventions A. The Prescriber’s Role B. Prospective Adherence Assessment C. Effective Communication, Relationships, and Trust D. Active Listening E. Provide Clear and Specific Information F. Empathy and Emotional Support G. Review H. Patient-Related Physical Interventions I. Social and Economic Interventions J. Economic Interventions K. Social Support Interventions L. Peer Support Programs M. Interventions for Improvement N. Educational Interventions O. Cognitive and Behavioral Interventions P. Motivational Interviewing Q. Principles of MI R. Integrative Health Coaching S. Multidisciplinary Interventions T. Technical Interventions U. Simplifying a Regimen V. Technological Innovations W. Monitoring Adherence X. Review Y. Summary Section 5: Conclusion A. Summary B. Course Contributors C. References D. Congratulations!
Expert Reviewer: Christopher Reist, MD, MBA
Rebecca Smallwood, MBA, RN, has experience across multiple healthcare settings including: rural and urban acute care hospitals, public health, ambulatory surgery, higher education, and commercial healthcare learning organizations. Her roles have included: medical/surgical, ED, and OR Staff and Charge Nurse; Director of School Health Services/School Nurse; Public Health Epidemiology and Bioterrorism Preparedness Specialist; Infection Control Practitioner; Quality Management Specialist; Organizational Development Specialist and Educator. Prior to joining Relias as an acute care SME Writer in 2017 and Curriculum Designer in 2021, she provided consultation to Swank Healthcare and was the Director of Education Services for Health.edu, a division of Texas Tech University Health Sciences Center. Rebecca earned a diploma in nursing from Methodist Hospital School of Nursing in Lubbock, Texas in 1989 and an MBA from Wayland Baptist University in 2010 with an emphasis in healthcare administration.Disclosure: Rebecca Smallwood, MBA, RN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Dr. Reist is Professor Emeritus in the Department of Psychiatry and Human Behavior at the University of California, Irvine. He has served as Assistant Dean in the College of Medicine and the Director of Medical Research for the Long Beach Veterans Affairs Healthcare System. Formerly, he served as Chief of Mental Health, overseeing full service mental health care delivery to over 50,000 enrollees at the Long Beach VA Healthcare System. He was the Associate Director of the Southern California VA Mental Illness Research, Education, and Clinical Center (MIRECC), which is focused on improving long-term outcomes in chronic psychotic disorders through basic/clinical research and dissemination of evidence-based practices. Dr. Reist’s clinical interests include schizophrenia, impulsivity, PTSD, pharmacogenomics, and psychopharmacology. DoD, NIMH, and VA Medical Research have supported his research. Dr. Reist is a Distinguished Fellow of the Psychiatric Association, has been recognized as an Exemplary Psychiatrist by the National Alliance for the Mentally Ill, and is included in Best Doctors 2007-2019. He is the author of two books and over 75 original scientific articles. Disclosure: Christopher Reist, MD, MBA discloses the following potential conflict of interests/commercial interests: Relevant Financial Relationship with Alkermes as Grant/Research Support Relevant Non-Financial Relationship with No Entities Exists as a Contributor
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