If
an assessment of adherence is triggered, rapid assessments
can be conducted. Assessments can be designed to allow the
patient to self-report barriers to adherence. Quick surveys
can help to identify the need for more in-depth exploration
of these barriers during the office visit, and can help to
prioritize those issues that can be initially emphasized.
Typical survey questions:
•Review
of self-monitoring data and daily schedule
and activities
•Evaluation
of dietary intake,
depression
•Explanation
of missed appointments
•Laboratory
screening
•Review
of therapy complexity and
costs
•Assessment
of provider-patient
relationships
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Further assessments may include psychological evaluation,
such as a depression index or signs of problematic family
and support network dynamics. A self-reported questionnaire
on dietary intake and activity levels can help to identify
non-adherence to dietary and exercise recommendations.
Costs for therapies is a common barrier to adherence and
both costs of medications and type of insurance coverage may
make a difference in this aspect of treatment. In addition,
a discussion on the patient’s perceptions about the
complexity and burden of treatment will assist in
identifying the need to intervene in these areas.