Improving Patient Adherence: A Look at Causal Knowledge, Treatment Credibility, and Treatment Expectancy

Lack of patient adherence to Cardiac Rehabilitation programs is a commonly reported problem (Bryne, Walsh, & Murphy, 2005) and is associated with increased morbidity and re-hospitalization rates (Platt, Green, Jayasinghe, & Morrissey, 2014). Factors that can increase the perceived credibility and expectancy of a treatment program predict better adherence (Nock, Ferriter, & Holmberg, 2007). A better understanding of a treatment rationale may improve treatment credibility and expectancy. For this study, causal knowledge is examined as a way to increase understanding because it has been shown to increase acquisition and retention of novel medical information (Goldszmidt, Minda, Devantier, Skye, & Woods, 2011). This study examined whether provision of causal knowledge as an educational strategy influences treatment credibility and expectancy. Patient education sessions at a cardiac rehabilitation program were randomized to deliver either standard care materials (control group) or standard care with the addition of causal information (intervention group). Treatment credibility and expectancy were measured using the Patient Treatment Credibility and Expectancy Measure (PCEM). Ninety-four cardiac patients (M age = 66.01, 69.35% male) participated in the study. Those in the intervention group (n = 45) provided significantly higher treatment credibility ratings for the cardiac rehabilitation program than did those in the control group (n = 49), t(85.63) = -2.35, p =.021. Findings from this study will inform the patient care delivery at the cardiac rehabilitation program and hopefully will help to increase adherence