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Facilitating Treatment Adherence in Pain Medicine: Adherence—The Great Confounder 

Facilitating Treatment Adherence in Pain Medicine: Adherence—The Great Confounder
Facilitating Treatment Adherence in Pain Medicine: Adherence—The Great Confounder

Martin D. Cheatle

and Perry G. Fine

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date: 11 April 2021

Almost daily, we seem to be witnessing astonishing innovations in diagnostic technologies and the development of novel therapeutics. In spite of these advancements and other time-tested interventions to mange the major diseases including intractable pain, patient nonadherence continues to undermine efforts to optimize individual and population health. The World Health Organization defines adherence as “The extent to which a person’s behavior taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a healthcare provider.” This definition implies that the patient-clinician relationship is based on a model of collaboration and patient-centeredness requiring time and resources which are scarce commodities in current practice. With these constraints in mind, acquiring skills to facilitate adherence to prescribed therapies and healthy lifestyle behaviors is critical to improving clinical outcomes.

In this chapter we will review the evolution of the concept of adherence, the incidence of nonadherence, factors influencing adherence behavior and provider and nonprovider enhancement of adherence.

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