Improving Adherence to Medical Advice

Adherence to medical advice is crucial for effective treatment and positive health outcomes. However, non-adherence is a widespread problem, leading to adverse consequences for individuals and healthcare systems. Psychologists have investigated factors influencing adherence and developed strategies to improve it. This essay will evaluate key psychological findings in this area, focusing on experimental evidence and discussing issues such as experimental design, ethics, generalisability, usefulness, reductionism, and determinism.

Experimental Evidence and Design

Experiments provide valuable insights into adherence-enhancing strategies. For example, Yokley and Glenwick (1984) investigated the impact of appointment reminders on childhood immunisation adherence. Using an independent measures design, they found that tailored reminders, including specific information about the child and clinic, significantly increased adherence compared to standard reminders or no reminders. Watt et al. (2003) explored the effectiveness of a "Funhaler," a device incorporating toys and positive reinforcement, in improving adherence to asthma medication among children. This repeated measures design study showed that children using the Funhaler demonstrated significantly higher adherence than those using a traditional inhaler.

While both studies offer valuable findings, methodological considerations arise. Field experiments like these offer real-world applicability but often face challenges in controlling extraneous variables. The researchers attempted to mitigate this through standardized procedures and clear IV manipulation, enhancing validity and reliability. However, measuring adherence accurately can be challenging. Yokley and Glenwick utilized immunization records, providing objective data, but Watt et al. relied on parental reports, potentially subject to bias.

Ethical Considerations

Ethical considerations are paramount in adherence research. Studies involving interventions must ensure informed consent, confidentiality, and minimize potential harm. For instance, withholding potentially effective interventions from control groups raises ethical concerns. Researchers must carefully balance the need for rigorous methodology with ethical obligations.

Generalisability and Usefulness

Generalizing findings from specific populations and settings to broader contexts is crucial. For example, studies focusing on childhood adherence may not directly translate to adult populations. Additionally, cultural factors and healthcare system variations can influence adherence behaviors. Research findings should be interpreted within their specific contexts, and interventions tailored accordingly. Despite these limitations, understanding factors influencing adherence, such as those highlighted in the discussed experiments, provides valuable insights for developing interventions applicable across diverse populations.

Reductionism and Determinism

Critiques of reductionism and determinism are relevant in adherence research. Attributing adherence solely to individual factors like knowledge or motivation oversimplifies a complex interplay of individual, social, and systemic factors. Deterministic views, suggesting adherence is predetermined, neglect the role of individual agency and decision-making. A holistic approach, considering the dynamic interplay of multiple factors, is crucial for understanding and improving adherence.

Conclusion

Psychological research has significantly advanced our understanding of adherence to medical advice. Experiments, like those discussed, provide valuable insights into effective strategies. While methodological limitations and ethical considerations warrant attention, findings contribute to developing interventions to enhance adherence. Recognizing the importance of generalisability, considering cultural and contextual factors, and adopting a holistic perspective that avoids reductionism and determinism are crucial for developing effective interventions that promote positive health outcomes.

References

Watt, H. C., Milnes, L., Elliott, J., & Thomas, N. (2003). Asthma medication adherence in children: A funhaler® versus traditional device randomized controlled trial. Respiratory medicine, 97(10), 1086-1091.

Yokley, J. M., & Glenwick, D. (1984). Increasing pediatric appointment keeping: A comparison of telephone and mail reminders and a combined interaction strategy. Journal of Pediatric Psychology, 9(1), 33-46.