Medication adherence as a learning process: insights from cognitive psychology.

Non-adherence to medications is one of the largest contributors to sub-optimal health outcomes. Many theories of adherence include a ‘value–expectancy’ component in which a patient decides to take a medication partly based on expectations about whether it is effective, necessary, and tolerable. We p...

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Publicado en:Health Psychology Review Vol. 11; no. 1; pp. 17 - 33
Autores principales: Rottman, Benjamin Margolin, Marcum, Zachary A., Thorpe, Carolyn T., Gellad, Walid F.
Formato: research tables/charts Journal Article
Publicado: Taylor & Francis Ltd Mar2017
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Taylor & Francis Ltd
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        atl: Medication adherence as a learning process: insights from cognitive psychology.
      aug:
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          Rottman, Benjamin Margolin
          Marcum, Zachary A.
          Thorpe, Carolyn T.
          Gellad, Walid F.
        affil: Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
      sug:
        subj:
          Ajzen's Theory of Planned Behavior
          Medication Compliance
          Learning
          Psychology
          Delayed Onset
          Psychology, Applied
      ab: Non-adherence to medications is one of the largest contributors to sub-optimal health outcomes. Many theories of adherence include a ‘value–expectancy’ component in which a patient decides to take a medication partly based on expectations about whether it is effective, necessary, and tolerable. We propose reconceptualising this common theme as a kind of ‘causal learning’ – the patient learns whether a medication is effective, necessary, and tolerable, from experience with the medication. We apply cognitive psychology theories of how people learn cause–effect relations to elaborate this causal-learning challenge. First, expectations and impressions about a medication and beliefs about how a medication works, such as delay of onset, can shape a patient’s perceived experience with the medication. Second, beliefs about medications propagate both ‘top-down’ and ‘bottom-up’, from experiences with specific medications to general beliefs about medications and vice versa. Third, non-adherence can interfere with learning about a medication, because beliefs, adherence, and experience with a medication are connected in a cyclic learning problem. We propose that by conceptualising non-adherence as a causal-learning process, clinicians can more effectively address a patient’s misconceptions and biases, helping the patient develop more accurate impressions of the medication.
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        tables/charts
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    language: English
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