M. Robin DiMatteo, Tricia A. Miller, and Leslie R. Martin
This essay examines issues relevant to the accurate assessment of patient adherence to recommendations for health behavior change and/or the management of medical conditions, including long-term chronic diseases. Both conceptual and methodological issues are discussed. The importance of accurate assessment in both clinical practice and research is examined, as well as the consequences of conceptual and measurement biases. The role of assessments of current adherence in predicting future behavior is examined, as is the essential distinction between assessing adherence as a behavior and assessing the predictors and consequences of adherence. The potential challenges of various approaches to assessing adherence accurately are examined, focusing particularly on self-report; measurement scales for adherence are presented; and innovative techniques are discussed for assessing adherence using technologically based formats. Effective communication is emphasized as the most important and salient element relevant to adherence assessment, linking patient adherence assessment with effective communication in the clinical setting.