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Home > About OBSSR > History > Adherence Research Network
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NIH Adherence Research Network |
Several recent reports and literature reviews point to the continuing need for
improving adherence to therapeutic regimens. Adherence rates vary considerably
across diseases and treatments, measuring instruments, and populations, with
rates ranging from 30% to 60% in many instances. Most researchers agree that
at least 50% of persons for whom drugs are prescribed fail to receive the full
benefit through inadequate adherence. As noted by the American Heart Association
(1997), the rationale for enhancing [adherence] is based on the premise that the
patient will get well or stay well if the physician, other healthcare providers,
and the healthcare organization make appropriate recommendations, providing the
patient has the requisite knowledge, motivation, skills, and resources to follow
the recommendations.
Lack of adherence to therapeutic regimens may result in poorer health for
individuals as well as economic costs for their health-care organizations and
the broader society. The reasons for non-adherence are multifaceted and not
fully understood. Health-care providers, organizational systems, and personal
factors all play a role in adherence to therapeutic regimens. Thus, to understand
and eventually improve adherence, conceptual frameworks and interventions need to
take into account institutional, system, situational, interpersonal, and personal
factors as well as the characteristics of the illness or condition and of the
treatment regimen.
Research has demonstrated the efficacy of a variety of approaches to improving
adherence to therapeutic regimens in controlled laboratory or field experimental
situations, in small, selected samples, or over limited periods of time. Less is
known about the effectiveness of interventions when they are moved from controlled
research settings to where health care is actually practiced with individuals of
varied backgrounds over extensive periods of time. How does the success of
interventions to improve adherence vary across types of health-care providers,
settings, and persons of varying educational, economic, and ethnic backgrounds?
What adjustments may be needed to implement interventions in the real world of
health care and under what circumstances? In addition to research on effectiveness,
opportunities may exist for research on adapting and assessing the efficacy of
promising intervention strategies that have been used successfully to improve
adherence, but in small, selected (e.g., unrepresentative) samples. Similarly,
behavior-change strategies that have been successful in one domain may hold
promise for improving adherence to therapeutic regimens for other illnesses or
health conditions.
In response to the public health significance of such issues as these, the
National Institutes of Health (NIH)
has issued a number of funding announcements in order to encourage fundamental
and translational research. Among these is the Request for Applications (RFA) on
Testing Interventions to Improve Adherence to Pharmacological Treatments.
Under the leadership of the Office of Behavioral and Social Sciences Research (OBSSR),
an informal network of program officers at several NIH Institutes, Offices, and
Centers emerged out of the cooperative efforts to issue and administer this RFA.
In order to encourage and facilitate further research on adherence, compliance,
and related issues, the NIH Adherence Research Network is developing this HomePage.
We intend to post information about:
Programs and initiatives at the NIH
Policies affecting research
Research resources (e.g., data sets)
Currently active funded research projects
Your suggestions for suitable subjects and services that we might provide the research
community are welcome. Please send comments to:
Lynn Bosco, MD, MPH
Medical Officer
Office of Behavioral and Social Sciences Research
Office of the Director
National Institutes of Health
Email: BoscoL@od.nih.gov
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