Educational Approaches

Education that is provided to a patient who is known to be nonadherent is different from the education that can be given as a preventive measure to an entire clinic population. Once the patient is known to be nonadherent, education can be interactive (involving a discussion about educational needs) and targeted (addressing specific areas of deficiency in knowledge). This education, therefore, is an individualized effort to establish what the patient needs to know or understand in order to improve his or her adherence. The components of this approach are the assessment of the patient's (and parent's) actual understanding of the prescribed regimen, its administration, and the reasons for it; the correction of any misinformed notions that are discovered; and an open discussion about how the medication is being taken, how it can be better integrated into a patient's lifestyle, and what concessions or resources are needed to make medication taking possible. Thus, education is an interactive process in which the clinician tries to identify and address the patient's cognitive and procedural needs.

Although educational approaches have been shown to have limited but significant effects on adherence (Becker and Allen 2001; Bender 2002) and to have only a small effect size in improving adherence (Kahana et al. 2008), they are considered "promising" in some disease categories (Lemanek et al. 2001). Because they are relatively straightfor ward and may not be labor intensive, they could be attempted as a first line of treatment, with the caveat that education alone might not be sufficient in some cases (Katz et al. 1998).

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