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The Expectation to Treatment Model: A Framework for Adherence and Effectiveness

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Developing Drug Products in an Aging Society

Part of the book series: AAPS Advances in the Pharmaceutical Sciences Series ((AAPS,volume 26))

Abstract

The decision to visit and seek help from a doctor is often derived from changes in perceived health conditions that affect the Quality of Life (QoL) and are judged as threatening. The disease diagnosis is a stressful event for an individual and might represent an important step in one’s life history. Healthcare professionals use a set of diagnostic tools to identify the reason for the health condition as well as propose a therapeutic intervention. The prescription of medicines is the most used intervention to interfere with the disease target, to manage or cure the disease according to the medical expectations. Once a person has accepted to be affected by a disease, one will deliberately or saliently form expectations in the proposed proceedings of the healthcare professional. If the expectations seem to be, the health care strategy will be evaluated and judged by the patient’s own bodily sensations, functioning, and wellbeing, as well as by the perceptions and beliefs about the type of coping strategy. If these evaluation confirms that the expectations are met, the patient will temporarily accept the therapy. During the course of drug therapy, the patient is exposed to the tangible disease as well as drug therapy-related effects. These can affect the patient’s perception of the therapy during its time and become inconsistent with one’s expectations and beliefs. Through the evaluation and constant reevaluation process of whether the drug therapy meets the patient’s personal expectations, the patient may consider modifications or apply changes to the drug therapy or coping strategy. The execution of the drug therapy is a goal-directed behavior that is initiated by the intention or a set of intentions by forming a plan (medication schedule and implementation plan) and the subsequent performance on following through the medication plan. The Expectation to Treatment Model acknowledges that with any coping strategy, intention and behavior remain a moving and dynamic interaction with the perceived risk-benefit balance and is centered on the patients’ (temporal) expectations, perceptions, and beliefs. Meeting patients’ expectations will be key in bridging the efficacy-effectiveness gap.

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Authors and Affiliations

  1. Graz University of Technology, Graz, Austria

    Sven Stegemann

  2. Capsugel, Bornem, Belgium

    Sven Stegemann

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    Sven Stegemann

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Stegemann, S. (2016). The Expectation to Treatment Model: A Framework for Adherence and Effectiveness. In: Stegemann, S. (eds) Developing Drug Products in an Aging Society. AAPS Advances in the Pharmaceutical Sciences Series, vol 26. Springer, Cham. https://doi.org/10.1007/978-3-319-43099-7_11

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