Table IV.
Perceived Barriers and Facilitators to Adherence Assessment and Intervention in Clinical Practice
| Barrier (N = 91) | Endorsed (%) | Top barrier (%) |
|---|---|---|
| Time limitations | 68.1 | 27.9 |
| Logistical challenges (e.g., clinic space/time) | 54.9 | 17.4 |
| Not familiar with available adherence assessments/interventions | 41.8 | 23.3 |
| Other presenting concerns (e.g., mood problems) prioritized over adherence concerns | 34.1 | 17.4 |
| Lack of reimbursement for adherence assessment/interventions | 23.1 | 3.5 |
| Adherence assessment/interventions not available for specific medical population | 13.2 | 3.5 |
| Medical team not perceived as being appreciative of adherence promotion assessment/intervention | 13.2 | 2.3 |
| Disagreement within field regarding focus of adherence assessment/intervention | 4.4 | 2.3 |
| Othera | 14.3 | 2.3 |
| Facilitators | Endorsed (%) | Top facilitator (%) |
| Adherence was primary referral question | 77.0 | 47.7 |
| Other staff (e.g., medical team) valued adherence promotion assessment/intervention | 65.5 | 25.6 |
| Effective adherence assessment/interventions available for specific clinical populations | 37.9 | 17.4 |
| Adherence assessment/interventions reimbursable | 19.5 | 5.8 |
| Access to technological support for intervention or monitoring strategies for adherence assessment/intervention | 14.9 | 2.3 |
| Otherb | 4.6 | 1.2 |
aDo not have resources needed for electronic monitoring or other objective measures, adherence measures (e.g., pencil and paper versions) not standard practice in current place of employment, no access to patient’s medical records outside of psychology, lack of available measures that accurately capture range of barriers to adherence which families endorse or that are focused on adherence behavior targeted in practice, family not interested in adherence-focused services.
bStaff support including graduate assistants and pharmacy staff, patient/family readiness to change.