A Patient-Centered Perspective on Medication Use: Self-Management Versus Adherence

Bruce Lambert, Ph.D., is an academic social scientist who has extensive experience in health communication, patient safety, medication errors, medical liability reform, medical informatics, and pharmacoepidemiology and numerous publications in these fields. He is a professor in the Department of Communication Studies and the founding director of the Center for Communication and Health at Northwestern University. The center is dedicated to using the communication arts and sciences to solve important problems of health-care quality, safety, and efficiency. Dr. Lambert currently is the principal investigator of the Northwestern University Center for Education and Research on Therapeutics, which focuses on studying techniques for optimizing medication safety.

In this series of three lectures, Dr. Lambert maintains that modern thinking about adherence—which is based on the assumption that people automatically follow their health care professional’s recommendations or that they do not do so because of forgetfulness or misunderstanding—is missing the mark. To understand adherence, he says, researchers should ask, "What would it be like if we took a patient-centered approach to this problem of adherence or self-regulation?"

A Patient-Centered Perspective on Medication Use: Self-Management Versus Adherence, Part 1

Part 1 (YouTube) summarizes the problem of nonadherence, presents the trajectory model that offers an authentic patient-centered account of chronic illness, and describes the motivations of people who have a chronic illness to keep their body, biography, and identity in coherent alignment.

A Patient-Centered Perspective on Medication Use: Self-Management Versus Adherence, Part 2

Part 2 (YouTube) summarizes the problem of how regimens both cause and cure body "failures" and how such failures can cause poor performance, loss of self, and suffering. Thus, Dr. Lambert asserts, medications have meaning that can weigh heavily on a patient, especially when the decision to take or not to take a medicine is fundamentally a decision to be or not to be a certain kind of person.

A Patient-Centered Perspective on Medication Use: Self-Management Versus Adherence, Part 3

Part 3 (YouTube) proposes directions and hypotheses for research and acknowledges the continuing need for an accurate model of human motivation, cognition, choice, and decisionmaking.

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