title: Physicians' communication of the common-sense self-regulation model results in greater reported adherence than physicians' use of interpersonal skills.
abstract: OBJECTIVE
  Interventions that address patients' illness and treatment representations have improved patient adherence and outcomes when administered by psychologists and/or health educators and focused on a single chronic illness. The current study assesses the potential feasibility/effectiveness of an intervention based on the common-sense self-regulation model (CS-SRM) when administered by providers in a primary care setting.
  
  
  METHODS
  We designed a prospective, correlational study in order to optimize patients' and providers' time and to gain initial evidence of the CS-SRM-approach's feasibility/effectiveness.
  
  
  METHODS
  Patients (n= 243) were recruited from a primary care waiting room and reported on objective behaviours of their providers (providers' CS-SRM-related behaviours and interpersonal skills) and other theoretically related measures directly after the medical encounter and reported on adherence, presenting problem resolution, and emergency care usage 1 month later.
  
  
  RESULTS
  The more providers gave their patients an adaptive understanding of their presenting problem/treatment (the greater the number of CS-SRM-related behaviours they engaged in), the more adherent were patients in the month following the encounter and the better was their problem resolution 1 month later. The CS-SRM-related behaviours were more predictive of these outcomes and emergency care usage than were the providers' interpersonal skills.
  
  
  CONCLUSIONS
  In the time-limited encounter, interventions may have to prioritize theoretical approaches for attaining patient adherence. The current study, although correlational, indicates that addressing the patients' illness/treatment representations is more important than the providers' interpersonal skills for attaining patient adherence and provides preliminary evidence that a CSM-based intervention in the primary care setting may be both feasible and effective.
authors: Institute for Health, Health Care Policy, and Aging Research, Rutgers University, 112 Paterson Street, New Brunswick, NJ 08901, USA. lphillips@ifh.rutgers.edu
authors: L Alison
authors: LA
authors: Phillips
authors: Howard
authors: H
authors: Leventhal
authors: Elaine A
authors: EA
authors: Leventhal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000523:psychology*; D003142:Communication; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care; D011340:Problem Solving; D011446:Prospective Studies