Prediction of adherence using the Transtheoretical model: Implications for pharmacy care practice

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Practical and theoretically derived intervention techniques are needed to improve adherence with prescription medications. Recently, there has been increased attention on the potential applicability of the Transtheoretical Model of Change (TTM) to intervening on medication adherence. This paper compares the predictive ability of the constructs of the TTM to static predictors (i.e., demographics and sexual history characteristics) in the area of adherence with oral contraceptives, a daily medication. Three hundred and six pill users from two community samples responded to an anonymous questionnaire regarding pill use and the TTM constructs. Hierarchical multiple regressions indicated that demographic and sexual history variables did not add significantly to the prediction of adherence based on the TTM constructs. Moreover, stage of adherence emerged as a strong and significant predictor and the model constructs accounted for a large proportion of the variance in nonadherence. The ability of the TTM's constructs to predict nonadherence is of particular importance given that this research addressed a difficult question by restricting the range of prediction to current pill users and not including individuals who had discontinued pill use. Discontinuation is presumably easier to predict because it is the most extreme form of nonadherence. Implications for individualizing interventions within pharmacy practice to improve adherence with OC and other prescription medications are discussed.

Publication Title

Journal of Social and Administrative Pharmacy





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