DETERMINANTS OF COMPLIANCE & PERSISTENCE WORKING GROUP

Chair:
Maribel Salas MD, DSc, MSc, Associate Medical Director US Patient Safety AstraZeneca, LP Wilmington, DE

Goal:
Develop standards for analyses of medication compliance and treatment persistence and their relationship to health outcomes. Working Group on Determinants of Medication Compliance and Persistence.

Tasks:

A. To update a review of interventions used to improve medication compliance and persistence.

Purpose: In order to delineate the determinants of medication compliance and persistence, we need to first have an understanding of reported interventions. The review will include a breakdown of whether or not these interventions are based on any kind of a theoretical framework or are reproducible.
Rationale: Targeting medication compliance and persistence as outcomes requires assurance that the interventions are both measurable and reproducible in order to be used by others.
Approach: As a starting point for this goal, we will look at current reviews that have been completed by DiMatte, Roter, Cochrane Collaboration, and others that the group identifies. We will subsequently evaluate the potential gaps in these reviews in order to develop a working piece that will form the foundation of the development of a white paper about the determinants.

B. To develop a framework or conceptual model of understanding what types of determinants can be involved in medication compliance and persistence.

Purpose: The determinants of noncompliance will be contingent on the disease-state as well as the research design and the other outcomes that are being considered.
Rationale: Establishment of a framework will provide guidance to researchers on how to fully review the literature in advance of designing the trial. This will ensure that appropriate covariates that potentially impact on compliance can be collected or that surrogate variables are included within the data collection framework.
Approach: We will explore which studies include theoretically grounded interventions using models such as the Health Belief Model, the Health Decision Making Theory as well as others that can be found on the NIH website (Theory at a Glance: A Guide for Health Promotion Practice http://www.cancer.gov/aboutnci/oc/theory-at-a-glance)

C. Synthesize

Consolidation of research in items A and B.
To develop a guidance document on the design and analysis of research to study the determinants of compliance.

Standardizing Definition of terms