Payer Perspective: Adherence for Clinicians

Payer Perspective: Adherence for Clinicians 

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.


Hours: 1.25


Certificates provided by accrediting body (13 Match)

Association of Social Work Boards

1.25 HOURS

Relias, LLC, #1273, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Relias LLC maintains responsibility for this course. ACE provider approval period: 02/10/2018-02/10/2021.

Course Delivery Format: Asynchronous Distance Learning-interaction includes quizzes with questions and answers, post-tests. This module is Reading-Based.

Social workers completing this course receive 1.25 Clinical continuing education clock hours.

New York State Education Department, Office of the Professions, Division of Professional Licensing Services, Social Work Unit

1.25 HOURS

Relias, LLC is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0009.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of licensed master social work and licensed clinical social work in New York. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice for an LMSW and LCSW. A licensee who practices beyond the authorized scope of practice could be charged with unprofessional conduct under the Education Law and Regents Rules.

As a provider of online, asynchronous education, some courses offered by Relias Learning are considered “self-study” under section 74.10(c)(2)(ii)(b)(4) of the Commissioner’s Regulations. The regulations limit self-study activities taken from a provider approved by the Education Department to no more than 12 hours in the 36-month registration period or one-third of the hours in a registration period other than 36 months.

Social workers will receive 1.25 continuing education hours for participating in this course. This activity is approved for 1.25 contact hours.

California Board of Registered Nursing

1.25 HOURS

Provider approved by the California Board of Registered Nursing, CEP# 13791

Nurses will receive 1.25 contact hours for participating in this course.

District of Columbia Board of Nursing


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 1.20 contact hours for participating in this course.

Florida Board of Nursing


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

American Nurses Credentialing Center

1.25 HOURS

Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 1.25 contact hours for participating in this course.

Georgia Board of Nursing

1.25 HOURS

Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.25 contact hours for participating in this course.

Accreditation Council for Continuing Medical Education

1.25 HOURS

Relias LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Relias LLC designates this enduring material activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

South Carolina Board of Nursing

1.25 HOURS

This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

Florida Board of Medicine

1.25 HOURS

Florida Board of Medicine CE Provider #: 50-290

Florida Physician Assistants

1.25 HOURS

West Virginia Board of Registered Nursing

1.25 HOURS

Commission for Case Manager Certification

1.25 HOURS

This activity is approved for 1.25 CE Contact Hours.

Course Details

Course Code: REL-PI-0-P91
Hours: 1.25
Type: Online Course
Content Expiration Date: 12/31/2020
Learning Objectives:
Differentiate between intentional and unintentional non-adherence.
Describe factors that influence therapeutic non-adherence.
Select appropriate interventions based on factors that influence non-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!

Staff Writer: Rebecca Smallwood, MBA, RN
Rebecca Smallwood, MBA, RN, has over 25 years of experience across a spectrum of healthcare settings including: rural and urban acute care hospitals, public health, ambulatory surgery center, higher education, and commercial organizations. Her roles have included: medical/surgical, ED, and OR staff nurse and charge nurse positions; director of health services / school nurse for PK-12th grades; public health epidemiology and bioterrorism preparedness professional; Infection control practitioner; quality management specialist; organizational development specialist; and educator. Prior to joining Relias Learning as a SME and Content Writer, she provided clinical and healthcare learning and development consultation to Swank Healthcare and was the Director of Education Services for, a division of Texas Tech University Health Sciences Center. She has authored over 100 live and web-based educational presentations and articles on clinical, patient safety, regulatory, leadership, patient experience, and performance improvement topics. Rebecca earned a diploma in nursing from Methodist Hospital School of Nursing in Lubbock, Texas in 1989 and an MBA in Healthcare Administration from Wayland Baptist University in 2010. Disclosure: Rebecca Smallwood, MBA, RN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Expert Reviewer: Christopher Reist, MD, MBA
Dr. Reist is an Associate Professor (with tenure) in the Department of Psychiatry and Human Behavior at the University of California, Irvine. He also serves 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 40,000 enrollees at the Long Beach VA Healthcare System. For the past 12 years, he has served as 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. NARSAD, NIMH, and VA Medical Research have supported his research. He has served as principal investigator on over 25 clinical trials in areas including schizophrenia, depression, bipolar disorder and impulsivity. He is a member of professional societies, including the American Psychiatric Association, Pacific Rim Association for Clinical Pharmacogenetics, and the Society of Biological Psychiatry. He 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 2007-2010. He is the author of two books, Psychiatry and Psychiatric Drugs, which have been widely used by trainees for the past 15 years. He has over 50 scientific articles that have been published in high-impact journals, including Molecular Psychiatry, Biological Psychiatry, Journal of Clinical Psychiatry, American Journal of Psychiatry, and Nature Biotechnology. Lastly, he has extensive experience in psychiatric education that include organizing CME conferences and developing web content that provide information on psychiatric disorders and treatment. Disclosure: Christopher Reist, MD, MBA discloses the following potential conflict of interests/commercial interests: Relevant Financial Relationship with Alkermes as Grant/Research Support
Target Audience:
The target audience for this course is: Nurses; Physician Assistants; Physicians; in the following settings: All Healthcare Settings.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form ( or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
If you require special accommodations to complete this module, please contact Relias Customer Support here.