Baylor professor develops questionnaire for patients aimed at promoting treatment adherence

Effectiveness in preventing or treating serious medical conditions typically requires patients to follow treatment plans such as medication, exercise or diet, but about 50 percent of patients fail to adequately use those plans. A Baylor University psychology professor has developed a questionnaire for patients aimed at promoting treatment adherence and improved health.

"It is crucial to have a well-validated instrument to assess patient adherence perceptions, including patient perceptions of their own behavior as well as patient perceptions of the benefits or burdens associated with adherence," said Keith Sanford, Ph.D., professor of psychology at Baylor University, in his study -; "Treatment Adherence Perception Questionnaire: Assessing Patient Perceptions Regarding their Adherence to Medical Treatment Plans" - published in the journal Psychological Assessment.

Our research shows that attitudes predict self-reported adherence. If people fail to adhere to their treatment plans, then their treatments may fail to work. The World Health Organization advises that it is important to find ways to improve treatment adherence and suggests this may have a greater overall impact on population health than improvements to any specific medical treatment."

Keith Sanford, Ph.D., professor of psychology, Baylor University

Sanford led the study on identifying the core types of attitudes essential for understanding whether people adhere to medical treatment plans. With the help of Baylor doctoral candidate Shelby Rivers, Sanford developed the Treatment Adherence Perception Questionnaire (TAPQ), a brief self-report tool.

Developing the TAPQ

Sanford and his team developed pools of questionnaire items asking people to rate types of thoughts they might have about their treatment plans, then tested those items on multiple samples of patients to determine which types elicited meaningful responses.

The study included 891 participants who had serious medical conditions and were advised to follow treatment plans. They were asked to fill out the 16-question TAPQ. After receiving the responses, the Baylor researchers used a procedure called factor analysis to identify the attitudes that underly people's responses, Sanford said.

"We created scales measuring two identified attitudes -; perceived benefit and perceived burden -; and conducted studies giving questionnaires to medical patients," Sanford said. "We tested how the two attitudes were correlated with other important target variables such as alliance with physician, confusion over medical information, emotions about treatment, motivation for treatment and self-reported adherence."

Perceived benefit is strongly associated with a person's motivation to adhere to treatment, while perceived burden is strongly associated with a person's negative emotions about treatment. Both are related to a person's experience with a doctor, and they both predict self-reported treatment adherence, Sanford said.

What it means

Through this study, researchers found that the TAPQ can be valuable for use in future research regarding treatment adherence and possibly can be useful in for improving outcomes in clinical settings.

"Results (from the TAPQ) could be used to alert healthcare professionals to issues that need to be discussed or addressed with each patient, which in turn might improve adherence and health outcomes," Sanford said.