Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis

• Published in: International journal of environmental research and public health Vol. 20; no. 5; p. 3869
• Main Authors: Laranjeira, Carlos, Carvalho, Daniel, Valentim, Olga, Moutinho, Lídia, Morgado, Tânia, Tomás, Catarina, Gomes, João, Querido, Ana
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 22.02.2023; MDPI AG
• Subjects: Analysis; Behavior; Caregivers; Communication; Compliance; Concept analysis; Concept Formation; Decision making; Ecological approach; Evolution; Health aspects; Health care; Humans; Medical research; Medicine, Experimental; Mental Disorders; Mental Health; Mental health care; Mental illness; Mentally ill; Patient Compliance; Patient-centered care; Patients; Psychiatric services; Public health; Review; Therapeutic adherence; Portugal; concept analysis; ecological approach; therapeutic adherence; mental health
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph20053869

Patient therapeutic adherence lies at the core of mental health care. Health Care professionals and organizations play a major role in promoting adherence among people with mental disorders. However, defining therapeutic adherence remains complex. We used Rodgers’ evolutionary concept analysis to explore the concept of therapeutic adherence in the context of mental health. We conducted a systematic literature search on Medline/PubMed and CINAHL for works published between January 2012 and December 2022. The concept analysis showed that major attributes of therapeutic adherence include patient, microsystem and meso/exosystem-level factors. Antecedents are those related to patients, such as their background, beliefs and attitudes, and acceptance of mental illness–and those related to patient-HCP therapeutic engagement. Lastly, three different consequences of the concept emerged: an improvement in clinical and social outcomes, commitment to treatment, and the quality of healthcare delivery. We discuss an operational definition that emerged from the concept analysis approach. However, considering the concept has undergone evolutionary changes, further research related to patient adherence experiences in an ecological stance is needed.