Improving our Understanding of Patient Adherence in Gout

Medication adherence remains problematic in gout management. Previous work demonstrates that adherence can be classified into intentional and unintentional adherence. Intentional nonadherence is driven by patients’ beliefs and offers the opportunity for early interventions. This thesis aimed to extend the current literature by addressing several aims. The first study (described in Chapter Three) aimed to examine the Intentional Non-Adherence Scale (INAS) for assessing medication adherence in gout. This scale was found to be a reliable and valid tool for identifying people at heightened risk for nonadherence in gout. The second study (described in Chapter Four) aimed to explore the main motives behind medication nonadherence, using the INAS. This study concluded that the desire to lead a normal life and the strategy of testing the treatment limits were the main motives of nonadherence. The third study (described in Chapter Five) aimed to provide further understanding of how medication adherence is addressed in online gout educational resources, with a specific focus on main motives of nonadherence. The findings indicated limited adherence coverage and a narrow range of strategies, with a significant portion of resources failing to address the main motives of nonadherence. The fourth study (described in Chapter Six) aimed to investigate the feasibility and acceptability of using smartphone notifications to improve medication adherence through targeting the main motives of nonadherence. The findings showed that the intervention is highly implementable in clinical settings. In conclusion, this thesis provides more information on intentional nonadherence among people with gout. The research demonstrated that the INAS can serve as an effective tool to assess intentional nonadherence in gout and to understand the main motives behind this behaviour, providing potential targets for designing more tailored interventions and strategies. This research also provides practical guidance for educational content creators. Furthermore, this thesis suggests that smartphone-based intervention holds potential as a patient-centered approach to enhance medication adherence in gout.

Name thesis:degree_name

PhD

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Health Psychology

Grantor dc:publisher

ResearchSpace@Auckland

Year dc:date.issued

2023

Author dc:creator

• Emad, Yasaman

Advisors dc:contributor.advisor

• Petrie, Keith J
• Dalbeth, Nicola

Statement dc:rights

• Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Licence dc:rights.uri

• https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm

Handle dc:identifier.uri

https://hdl.handle.net/2292/68916

OAI identifier oai:identifier

oai:researchspace.auckland.ac.nz:2292/68916