Chronic nonadherence to therapeutic regimes : an in-depth analysis of male arthritis patients

Chronic nonadherence is the complete lack of adherence on the part of a patient to at least one aspect of their therapeutic regime for extended periods of time. Chronic nonadherence is similar to other forms of nonadherence in that it is a phenomena which is dangerous for patients, frustrating for practitioners, and costly to the health care system. However, unlike other forms of nonadherence, very little is known about this subject. In order to determine factors related to chronic nonadherence to a home exercise program, 15 male arthritis patients of varying ages underwent an in-depth structured interview. Eight of these patients were identified by the Arthritis Society as being chronic, treatment nonadherents. The other seven patients were randomly chosen from among the population of male arthritis patients in order to provide a comparison to the chronic nonadherent population. Ten variables were examined in this study in the hopes of determining factors related to chronic nonadherence. These variables were as follows: demographics, The Health Beliefs Model, patient's explanatory model, nature of the illness, satisfaction with practitioner attributes, shared responsibility, overall satisfaction, attitudes of significant others, use of unorthodox treatments, and problems with the home exercise program. Data analysis failed to produce any statistically significant findings, however the study did point to some interesting associations. One finding from this study is that nonadherence seems to be related to patient's Health Beliefs Models. Based on this finding the study then goes on to recommend an appropriate intervention which can be used by practitioners to enhance patient adherence. A second finding from this study is that a small number of the chronic nonadherent group were actually adherent to their home exercise programs. Several explanations have been provided as to how these patients might have been falsely labelled as chronic nonadherents.Arts, Faculty ofSocial Work, School ofGraduat