Factors associated with the accuracy of physicians' predictions of patient adherence

Objective: Physicians are inaccurate in predicting non-adherence in patients, a problem that interferes with physicians': (1) appropriate prescribing decisions and (2) effective prevention/intervention of non-adherence. The purpose of the current study is to investigate potential reasons for the poor accuracy of physicians' adherence-predictions and conditions under which their predictions may be more accurate. Methods: After the medical encounter, predictions of patient-adherence and other ratings from primary-care physicians (n = 24) regarding patient-factors that may have influenced their predictions were collected. Patients (n = 288) rated their agreement regarding the prescribed treatment after the encounter and reported adherence 1 month later. Results: Several factors were related to physicians' adherence-predictions, including physicians' perceptions of patient-agreement regarding treatment. However, some factors were not related to adherence and agreement-perceptions were inaccurate overall, potentially contributing to the poor accuracy of adherence-predictions. The degree to which physicians discussed treatment-specifics with the patient moderated agreement-perception accuracy but not adherence-prediction accuracy. Conclusions: Training providers to discuss certain treatment-specifics with patients may improve their ability to perceive patient-agreement regarding treatment and may directly improve patient-adherence. Practice implications: Discussing treatment-specifics with patients may directly improve adherence, but providers should not rely on these discussions to give them accurate estimates of the patients' likely adherence. (C) 2011 Elsevier Ireland Ltd. All rights reserved.