Do improved patient recall and the provision of memory support enhance treatment adherence?. (March 2017)

• Record Type: Journal Article
• Authors: Dong, Lu; Lee, Jason Y.; Harvey, Allison G.
• Is Part Of: Journal of behavior therapy and experimental psychiatry. Volume 54(2017)
• Page Start: 219
• Page End: 228
• Publication Date: 2017-03
• Subjects: Treatment adherence -- Memory support -- Cognitive therapy -- Transdiagnostic -- Depression -- Treatment development; Behavior therapy -- Periodicals; 616.89142
• DOI: 10.1016/j.jbtep.2016.08.017
• Languages: English
• ISSNs: 0005-7916

Abstract

Abstract: Background and objectives: Patient adherence to psychosocial treatment is an important but understudied topic. The aim of this study was to examine whether better patient recall of treatment contents and therapist use of memory support (MS) were associated with better treatment adherence. Methods: Data were drawn from a pilot randomized controlled trial. Participants were 48 individuals (mean age = 44.27 years, 29 females) with Major Depressive Disorder randomized to receive either Cognitive Therapy (CT) with an adjunctive Memory Support Intervention (CT + Memory Support) or CT-as-usual. Therapist and patient ratings of treatment adherence were collected during each treatment session. Patient recall was assessed at mid-treatment. Therapist use of MS was manually coded for a random selection of sessions. Results: Patient recall was significantly associated with better therapist and patient ratings of adherence. Therapist use of Application, a specific MS strategy, predicted higher therapist ratings of adherence. Attention Recruitment, another specific MS strategy, appeared to attenuate the positive impact of session number on patient ratings of adherence. Treatment groups, MS summary scores and other specific MS strategies were not significantly associated with adherence. Limitations: The measure for treatment adherence is in the process of being formally validated. Results were based on small sample. Conclusions: These results support the importance of patient recall in treatment adherence. Although collectively the effects of MS on treatment adherence were not significant, the results support the use of certain specific MS strategy (i.e., application) as a potential pathway to improve treatment adherence. Larger-scale studies are needed to further examine these constructs. Highlights: Patient's treatment adherence is relatively understudied in psychosocial treatments. Patient recall and Memory Support (MS) are important factors for treatment adherence. Patient recall of treatment contents was associated with improved adherence. Therapist use of Application (a specific MS) was associated with improved adherence.