Intentional and Unintentional Nonadherence: a Study of Decision Making

Overview

Journal J Behav Med

Specialty Social Sciences

Date 2002 Jul 26

PMID 12136497

Citations 99

Authors

Abigail L Wroe

Affiliations

Soon will be listed here.

Abstract

Nonadherence to medical regimens is a major problem in health care. Distinguishing between intentional nonadherence (missing/altering doses to suit one's needs) and unintentional nonadherence (forgetting to take medication) may help in understanding nonadherence. Participants with respiratory conditions completed an anonymous questionnaire about (i) nonadherence; (ii) reasons for and against taking medications; and (iii) perceived style of the consultation in which their medication was first prescribed, as well as demographic and clinical variables. Consistent with the hypotheses, intentional nonadherence is predicted by the balance of individuals' reasons for and against taking medication as suggested by the Utility Theory, where these reasons include only those which the individual considers relevant and on which he/she focuses. Unintentional nonadherence is less strongly associated with decision balance, and more so with demographics. The research highlights the importance of (a) treating intentional and unintentional nonadherence as separate entities and (b) assessing individuals' idiosyncratic beliefs when considering intentional nonadherence.

Citing Articles

Executive function performance in high and low medication adherent patients with euthymic bipolar i disorder: a comparative study.

Rahimi Chahooei M, Zahedi Tajrishi K, Zargarinejad G, Shabani A BMC Psychiatry. 2025; 25(1):239.

PMID: 40082820 PMC: 11905722. DOI: 10.1186/s12888-025-06665-y.

Proteomic changes upon treatment with semaglutide in individuals with obesity.

Maretty L, Gill D, Simonsen L, Soh K, Zagkos L, Galanakis M Nat Med. 2025; 31(1):267-277.

PMID: 39753963 PMC: 11750704. DOI: 10.1038/s41591-024-03355-2.

Longitudinal changes in self-reported medication adherence and beliefs about post-stroke medicines in Sweden: a repeated cross-sectional study.

Sjolander M, Gustafsson M, Holmberg H, Glader E BMJ Open. 2024; 14(10):e084680.

PMID: 39424386 PMC: 11492948. DOI: 10.1136/bmjopen-2024-084680.

The Impact of Home Medication Management Practices on Medication Adherence.

Gualtieri L, Steinfeldt M, Shaveet E, Estime B, Singhal M Behav Sci (Basel). 2024; 14(9).

PMID: 39336019 PMC: 11428923. DOI: 10.3390/bs14090804.

Using Games to Simulate Medication Adherence and Nonadherence: Laboratory Experiment in Gamified Behavioral Simulation.

Taj U, Grimani A, Read D, Vlaev I JMIR Serious Games. 2024; 12:e47141.

PMID: 39316506 PMC: 11444231. DOI: 10.2196/47141.

References

Sutherland H, Llewellyn-Thomas H, Lockwood G, Tritchler D, Till J . Cancer patients: their desire for information and participation in treatment decisions. J R Soc Med. 1989; 82(5):260-3. PMC: 1292127. DOI: 10.1177/014107688908200506. View

Horne R, Weinman J . Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 2000; 47(6):555-67. DOI: 10.1016/s0022-3999(99)00057-4. View

Spector S, Kinsman R, Mawhinney H, SIEGEL S, Rachelefsky G, Katz R . Compliance of patients with asthma with an experimental aerosolized medication: implications for controlled clinical trials. J Allergy Clin Immunol. 1986; 77(1 Pt 1):65-70. DOI: 10.1016/0091-6749(86)90325-8. View

Chambers C, Markson L, Diamond J, Lasch L, Berger M . Health beliefs and compliance with inhaled corticosteroids by asthmatic patients in primary care practices. Respir Med. 1999; 93(2):88-94. DOI: 10.1016/s0954-6111(99)90296-2. View

Becker L, Glanz K, Sobel E, Mossey J, Zinn S, Knott K . A randomized trial of special packaging of antihypertensive medications. J Fam Pract. 1986; 22(4):357-61. View

Fallowfield L, Hall A, Maguire G, Baum M . Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial. BMJ. 1990; 301(6752):575-80. PMC: 1663731. DOI: 10.1136/bmj.301.6752.575. View

Catz S, Kelly J, Bogart L, Benotsch E, McAuliffe T . Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychol. 2000; 19(2):124-33. View

Fincke B, Miller D, Spiro 3rd A . The interaction of patient perception of overmedication with drug compliance and side effects. J Gen Intern Med. 1998; 13(3):182-5. PMC: 1496921. DOI: 10.1046/j.1525-1497.1998.00053.x. View

Meyer D, Leventhal H, Gutmann M . Common-sense models of illness: the example of hypertension. Health Psychol. 1985; 4(2):115-35. DOI: 10.1037//0278-6133.4.2.115. View

10.

Cummings K, BECKER M, KIRSCHT J, Levin N . Intervention strategies to improve compliance with medical regimens by ambulatory hemodialysis patients. J Behav Med. 1981; 4(1):111-27. DOI: 10.1007/BF00844851. View

11.

Marinker M . Personal paper: writing prescriptions is easy. BMJ. 1997; 314(7082):747-8. PMC: 2126158. DOI: 10.1136/bmj.314.7082.747. View

12.

Rand C, Wise R . Measuring adherence to asthma medication regimens. Am J Respir Crit Care Med. 1994; 149(2 Pt 2):S69-76; discussion S77-8. DOI: 10.1164/ajrccm/149.2_Pt_2.S69. View

13.

Coons S, Sheahan S, Martin S, Hendricks J, Robbins C, Johnson J . Predictors of medication noncompliance in a sample of older adults. Clin Ther. 1994; 16(1):110-7. View

14.

Hershey J, Baron J . Clinical reasoning and cognitive processes. Med Decis Making. 1987; 7(4):203-11. DOI: 10.1177/0272989X8700700402. View

15.

Donovan J . Patient decision making. The missing ingredient in compliance research. Int J Technol Assess Health Care. 1995; 11(3):443-55. DOI: 10.1017/s0266462300008667. View

16.

Peterson L, Simonds J, Goldstein D, Kilo C, Hoette S . The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus. J Consult Clin Psychol. 1987; 55(2):139-44. DOI: 10.1037//0022-006x.55.2.139. View

17.

Bosley C, Fosbury J, COCHRANE G . The psychological factors associated with poor compliance with treatment in asthma. Eur Respir J. 1995; 8(6):899-904. View

18.

Beaver K, Luker K, Owens R, Leinster S, Degner L, Sloan J . Treatment decision making in women newly diagnosed with breast cancer. Cancer Nurs. 1996; 19(1):8-19. DOI: 10.1097/00002820-199602000-00002. View

19.

Wroe A, Salkovskis P, Rimes K . The effect of nondirective questioning on women's decisions whether to undergo bone density screening: an experimental study. Health Psychol. 2000; 19(2):181-91. DOI: 10.1037//0278-6133.19.2.181. View

20.

Degner L, Sloan J . Decision making during serious illness: what role do patients really want to play?. J Clin Epidemiol. 1992; 45(9):941-50. DOI: 10.1016/0895-4356(92)90110-9. View