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Clinical Pediatrics, Vol. 45, No. 5, 439-445 (2006)
DOI: 10.1177/0009922806289619

Physicians’ Attitudes and Practices Regarding Adherence to Medical Regimens by Patients with Chronic Illness

Uptal D. Patel, MD

Division of Pediatric Nephrology, Division of Nephrology VA Health Services Research & Development Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, MI.

Matthew M. Davis, MD, MAPP

Child Health Evaluation and Research Unit, Division of General Pediatrics, and Division of General Internal Medicine; all of the Departments of Pediatrics & Communicable Diseases and Internal Medicine, University of Michigan Health System

Health professionals often do not detect nonadherence despite substantial adverse impacts on health-care delivery and costs. We sought to determine how physicians assess and manage adherence among patients with chronic illness, and whether approaches to nonadherence differ by level of clinical training or prior training regarding adherence. Two-hundred seventeen pediatricians and internists completed an Internet-based survey. Responses demonstrated that few had previous formal training regarding patient adherence. Physicians’ assessment of nonadherence and knowledge and skills regarding strategies for improving adherence appeared significantly more advanced among physicians with more clinical experience and among those with formal training in adherence assessment and management. Formal educational interventions may improve adherence-related knowledge and skills.


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