Factors associated with the accuracy of physicians' predictions of patient adherence

Patient Educ Couns. 2011 Dec;85(3):461-7. doi: 10.1016/j.pec.2011.03.012. Epub 2011 Apr 17.


Objective: Physicians are inaccurate in predicting non-adherence in patients, a problem that interferes with physicians': (1) appropriate prescribing decisions and (2) effective prevention/intervention of non-adherence. The purpose of the current study is to investigate potential reasons for the poor accuracy of physicians' adherence-predictions and conditions under which their predictions may be more accurate.

Methods: After the medical encounter, predictions of patient-adherence and other ratings from primary-care physicians (n=24) regarding patient-factors that may have influenced their predictions were collected. Patients (n=288) rated their agreement regarding the prescribed treatment after the encounter and reported adherence 1 month later.

Results: Several factors were related to physicians' adherence-predictions, including physicians' perceptions of patient-agreement regarding treatment. However, some factors were not related to adherence and agreement-perceptions were inaccurate overall, potentially contributing to the poor accuracy of adherence-predictions. The degree to which physicians discussed treatment-specifics with the patient moderated agreement-perception accuracy but not adherence-prediction accuracy.

Conclusions: Training providers to discuss certain treatment-specifics with patients may improve their ability to perceive patient-agreement regarding treatment and may directly improve patient-adherence.

Practice implications: Discussing treatment-specifics with patients may directly improve adherence, but providers should not rely on these discussions to give them accurate estimates of the patients' likely adherence.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel*
  • Clinical Competence*
  • Cross-Sectional Studies
  • Female
  • Forecasting
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Patient Compliance*
  • Perception
  • Physician-Patient Relations*
  • Physicians
  • Practice Patterns, Physicians'
  • Predictive Value of Tests
  • Surveys and Questionnaires
  • Young Adult