What factors contribute to adherence to a routine?

From the Guidelines

Adherence to a routine is most effectively achieved by setting clear, specific, and realistic goals, creating a structured schedule, and using a combination of strategies such as simplification of complex treatments, patient education, and regular tracking of progress, as evidenced by the most recent and highest quality study 1. When considering the factors that contribute to adherence to a routine, it's essential to understand that adherence is a complex issue, influenced by multiple factors including patient education, treatment cost and complexity, and the presence of comorbid conditions, as noted in 1 and 1.

Key Factors for Adherence

• Setting clear, specific, and realistic goals, as this provides direction and measurable targets
• Creating a structured schedule with consistent timing for activities, which helps establish habits through repetition
• Using a combination of strategies such as simplification of complex treatments, patient education, and regular tracking of progress, as recommended in 1
• Building accountability through sharing the routine with others or using tracking apps to monitor progress
• Preparing the environment by removing obstacles and placing necessary items where they'll be needed
• Including rewards for milestone achievements to maintain motivation through positive reinforcement
• Allowing flexibility within the routine to accommodate unexpected events without completely derailing progress
• Connecting the routine to personal values and long-term objectives to strengthen commitment
• Practicing self-compassion when experiencing setbacks, as perfectionism can lead to abandoning routines entirely when minor deviations occur, as discussed in 1 and 1.

Importance of Recent and High-Quality Evidence

The most recent and highest quality study, 1, emphasizes the importance of a combination of strategies to improve drug adherence, including simplification of complex treatments and patient education. This study highlights the need for a multifaceted approach to addressing adherence, taking into account the various barriers that patients may face.

Clinical Application

In clinical practice, healthcare providers should prioritize the use of evidence-based strategies to promote adherence, such as those outlined in 1. By doing so, they can help patients achieve better outcomes, reduce morbidity and mortality, and improve quality of life. Regular assessment of adherence and addressing barriers to adherence are crucial components of effective routine management, as noted in 1 and 1.

From the Research

Factors Contributing to Adherence to a Routine

Several factors contribute to adherence to a routine, including:

• Habit strength: Studies have shown that habit strength is a significant predictor of adherence to medication and physical activity routines 2.
• Barriers: Treatment-specific barriers can also predict self-reported and objective adherence for both behaviors 2.
• Beliefs and experiential feedback: While beliefs are inconsistently related to behavior, experiential feedback from behavior is not related to adherence 2.
• Nurse-led interventions: Nurse-led face-to-face visits may be effective in improving medication adherence in people with chronic diseases 3.
• Motivational approach: The motivational approach is one of the most common strategies used to promote patient medication adherence 3.
• Reminders: Reminders, such as refill reminder calls or use of electronic drug monitors, can improve medication adherence rates 4, 5.
• Incentives: Incentives, such as reducing co-payments and paying patients and clinicians for achieving disease management goals, can also promote adherence 5.
• Medication regimen management: Using combination pills to reduce the number of pills patients take daily can improve adherence 5.
• Clinical pharmacist consultation: Clinical pharmacist consultation for chronic disease co-management can also improve adherence 5.
• Cognitive behavioral therapies: Cognitive behavioral therapies, such as motivational interviewing, can also promote adherence 5.

Habit Formation

Habit formation is an important aspect of adherence to a routine. Studies have shown that:

• IT habits appear to have a strong linkage with use adherence, whereas lifestyle habits did not seem to be directly related to weight loss 6.
• Habit formation stages provide a possible explanation for why self-monitoring, reminders, and tunneling were perceived as especially valuable features in promoting habit formation 6.
• Recognizing the stages of habit formation provides additional valuable guidance for designing systems that help shape an individual's habits 6.

Interventions to Improve Adherence

Various interventions can be used to improve adherence, including:

• Patient education: Recurrent and personalized telephone counseling sessions with health educators can improve adherence 5.
• Medication-taking reminders: Medication-taking reminders, such as refill reminder calls or use of electronic drug monitors, can improve medication adherence rates 4, 5.
• Gamified behavioral simulation: Gamified behavioral simulation can be a useful tool to explain real health behaviors and help in identifying which interventions are most likely to work in a randomized trial 4.