Atlantis Healthcare, a global leader in personalised health solutions, announced the adoption of a new health psychology approach to guide development of medication adherence support programmes. Created by a team of prominent health psychologists, the Intentional Non-Adherence Scale (INAS)
is an assessment tool that reveals previously unrecognised factors for why people choose to not take their medication, providing specialists with new territories in communications and education.
“The INAS greatly expands the understanding of non-adherence within healthcare, and highlights critical gaps in current interventions and programmes designed to improve adherence,” said John Weinman, Professor of Psychology as applied to Medicines at King’s College, London. Professor Weinman is co-principal author of the INAS research with Keith Petrie, Professor of Health Psychology, University of Auckland Medical School, New Zealand.
“The great advantage of the INAS assessment is that the scale provides insights into the specific reasons why patients don’t take their medication. This opens up the potential to specifically target these drivers in an intervention,” said Professor Petrie.
Professors Weinman and Petrie have led the global health psychology team at Atlantis Healthcare for over ten years. Professor Weinman was recently awarded the status of Distinguished International Affiliate by the American Psychological Society’s Division of Health Psychology, currently held by only 32 academics worldwide, in recognition of outstanding contributions to health psychology. Professor Petrie was awarded the Mason Durie Medal in 2015 for his research into patients’ perceptions of illness and how these perceptions impact recovery and coping.
“The INAS questions are very targeted and are seldom raised with patients or health consumers,” said Jonny Duder, CEO, Atlantis Healthcare. “This new ‘lens’ allows us to evolve our research and solution design methodologies, as well as review existing interventions to identify areas for optimisation. We are now working with a number of healthcare stakeholders who are asking us to leverage this new tool to assess their programmes globally.”
New Understandings About Non-Adherence
According to Professors Weinman and Petrie, the goal of this research was to develop and test a scale that could assess different components of non-adherence and help explain variance in adherence using both subjective (self-report) and objective (clinical) measures. As with other foundational health psychology approaches, the research focused on the underlying beliefs driving non-adherent behaviours.
Among valuable insights, the 22-item scale revealed two important factors not included in other widely used theoretical frameworks
- Resisting Illness – defined as a reluctance to take medicines regularly because they are a constant reminder of an illness, and signal a desire to feel normal again
- Testing Treatment – including reasons for omitting or reducing treatment, including whether they could “do without it” or “really need it”
The discovery of additional drivers behind intentional non-adherence represents an evolution of current health psychology theory, and has potential to add to the effectiveness of both theoretical and practical interventions in patient support. While the pivotal research assessed patients in oncology, hypertension and gout, the scale is likely to be relevant for individuals taking prescribed medication across chronic conditions.
“This new scale can be applied in the early research stages of program development to guide selection of behaviour change techniques, as well as inform content development of communications and educational materials,” said Professor Weinman.
The Intentional Non-Adherence Scale (INAS): Initial Development and Validation. Journal of Psychosomatic Research
115 (December 2018) 110-116
Beliefs about Medicines Questionnaire (BMQ) and Patient Activation Measure (PAM)