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

Br J Health Psychol. 2012 May;17(2):244-57. doi: 10.1111/j.2044-8287.2011.02035.x. Epub 2011 Jun 15.

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease / psychology*
  • Communication*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Patient Satisfaction*
  • Physician-Patient Relations*
  • Physicians, Primary Care
  • Problem Solving
  • Prospective Studies