The research that has been carried out has also tended to ignore the various patterns of adherence that may occur. These patterns range from failing to participate in the regimen altogether, to variability in regimen conduct, to timing errors, all of which can contribute to variations in clinical outcome. To move the understanding of adherence behaviors forward, the research needs to become more specific about the definition of adherence, its pattern, and the type of adherence problem being addressed. The use of electronic monitors and potentially diaries in the assessment of adherence will allow these subclassifications of poor adherence to be better identified and characterized.
As the clinical outcomes associated with poor adherence have become more salient and the costs have impact on a cost-conscious health care system, the interest in adherence has increased. The newer measurement technologies permit a more refined and specific assessment of adherence problems and patterns, which is contributing toward a finer understanding of this significant problem in health care. The limited studies detailing the problems of adherence, the paucity of intervention studies, as well as the variability created by the coarser view of adherence that has characterized research in the field all point to the need for further focused research in this difficult problem affecting all aspects of health care.
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