Implicit determinants of medication adherence

Medication adherence is not optimal in patients with rheumatoid arthritis and varies between 22% (underuse) and to 107% (overuse). Medication non-adherence is a relevant clinical problem as it can result in more disease activity, radiological damage, a lower quality of life, and increased health care costs. Thus, effective interventions to improve medication adherence are warranted. However, current methods to improve medication adherence for chronic health problems are only partially effective, so that the full benefits of treatment cannot be realized. A potential explanation for the limited effectiveness of current interventions is that they predominantly focus on only one target population (e.g., patients) and on explicit intervention targets (i.e., patients’ self-reported attitudes toward their medication and their self-reported reasons for not taking the medication as prescribed). Recent studies, however, show that current methods overlook the role of (1) the physician and (2) more automatic or subconscious intervention targets like patients’ implicit attitudes. Clearly, intervening on the patient’s explicit attitudes toward their medication only will not solve the adherence problem.

This project will further explore the interplay between physician’s and patient’s attitudes toward medication (both implicit and explicit), the (dis)concordance of both, and their influence on medication adherence and clinical outcomes. Knowing this, a more effective adherence communication intervention might be developed. This is a collaboration between Bart van den Bemt of the Sint Maartenskliniek/Radboud UMC (principal investigator), Annemiek Linn and Lisa Vandeberg (ASCoR), Alfons den Broeder and Els van den Ende (Sint Maartenskliniek), Liset van Dijk, Marcia Vervloet, and Sandra van Dulmen (NIVEL), and Mike Nurmohamed (Reade).

Research team: Bart van den Bemt (Sint Maartenskliniek Nijmegen/Raboud UMC)
Annemiek Linn (Amsterdam School of Communication Research, University of Amsterdam)
Lisa Vandeberg (Amsterdam School of Communication Research, University of Amsterdam)
Alfonds den Broeder (Sint Maartenskliniek Nijmegen)
Els van den Ende (Sint Maartenskliniek Nijmegen)
Liset van Dijk (NIVEL)
Marcia Vervloet (NIVEL)
Sandra Van Dulmen (NIVEL)
Mike Nurmohamed (Reade)
Status: Start in Januari 2016
Funding: Reumafonds