Research Article

Interdisciplinary Medication Adherence Program: The Example of a University Community Pharmacy in Switzerland

Table 1

Patient-level intervention according to Michie’s et al. taxonomy [26].

Michie’s et al. taxonomyIntervention

Goals and planningSet realistic goals and adjust them to build up skills, use the problem solving technique, and raise awareness on discrepancy between current behavior and goals as a motor of change

Feedback and monitoringElectronic monitoring, empathic reinforcement, alliance through LCD display of electronic pill monitor, and ensuring continuity of care through medication adherence report

Social supportReinforce positive practical and/or emotional support, invite significant others to attend interview, and offer the possibility to bring adherence report back home to discuss it with significant others

Shaping knowledgeAssess patient’s cognitive and behavioral knowledge and needs in regard to long-term adherence, short-term and long-term side effects, fill in gaps with adequate vocabulary, and reevaluate needs over time

Natural consequencesEvaluate consequences, which are relevant to the patient (e.g., health, quality of life, and social, emotional, affective, financial, and professional consequences) and use hypotheses as a motor of potential changes (e.g., what would happen if you would take your medication on a regular basis?)

Comparison of behaviorAsk the permission for telling what other patients did in a similar situation

AssociationsAssociate drug intake with relevant individual daily actions, behaviors, cues, and reminders

Repetition and substitutionPlan short but repeated interviews over time, adjusted to patients’ needs

Comparison of outcomesCompare change in clinical outcomes and in adherence and set future goals

Reward and threatCongratulate patient on achievements as small as they are; if necessary, evoke risks cautiously with patient agreement

RegulationDetangle possible triangulation between patient and healthcare providers, listen to and regulate emotions, and, if possible, wait and see if patient is not ready to change behavior (preparation phase)

AntecedentsEvaluate adherence with past treatments as indicator

IdentityReinforce patient positive behaviour, respect patient’s rhythm and possibilities, and keep contact with patient (e.g., schedule a new interview in case of a missed appointment)

Scheduled consequencesIdentify changes in clinical outcomes

Self-beliefExplore patient’s past success, empower patient, and support patient in building self-confidence, self-efficacy, and motivation with treatment

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