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Physicians’ communication of the common-sense self-regulation model results in greater reported adherence than physicians’ use of interpersonal skills

Authors


L. Alison Phillips, 112 Paterson Street, New Brunswick, NJ, 08901, USA (e-mail: lphillips@ifh.rutgers.edu).

Abstract

Objectives.  Interventions that address patients’ illness and treatment representations have improved patient adherence and outcomes when administered by psychologists and/or health educators and focused on a single chronic illness. The current study assesses the potential feasibility/effectiveness of an intervention based on the common-sense self-regulation model (CS-SRM) when administered by providers in a primary care setting.

Design.  We designed a prospective, correlational study in order to optimize patients’ and providers’ time and to gain initial evidence of the CS-SRM-approach's feasibility/effectiveness.

Methods.  Patients (n= 243) were recruited from a primary care waiting room and reported on objective behaviours of their providers (providers’ CS-SRM-related behaviours and interpersonal skills) and other theoretically related measures directly after the medical encounter and reported on adherence, presenting problem resolution, and emergency care usage 1 month later.

Results.  The more providers gave their patients an adaptive understanding of their presenting problem/treatment (the greater the number of CS-SRM-related behaviours they engaged in), the more adherent were patients in the month following the encounter and the better was their problem resolution 1 month later. The CS-SRM-related behaviours were more predictive of these outcomes and emergency care usage than were the providers’ interpersonal skills.

Conclusions.  In the time-limited encounter, interventions may have to prioritize theoretical approaches for attaining patient adherence. The current study, although correlational, indicates that addressing the patients’ illness/treatment representations is more important than the providers’ interpersonal skills for attaining patient adherence and provides preliminary evidence that a CSM-based intervention in the primary care setting may be both feasible and effective.

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