Journal of General Internal Medicine

, Volume 33, Issue 2, pp 207–215 | Cite as

Advantages to Using Social-Behavioral Models of Medication Adherence in Research and Practice

  • K. Rivet Amico
  • M. Mugavero
  • Marie A. Krousel-Wood
  • Hayden B. Bosworth
  • Jessica S. Merlin


Achieving and sustaining high levels of adherence to medication regimens is essential to improving health outcomes, but continues to be a challenge for a sizable proportion of patients. Decades of research suggests that medication adherence is determined by a complex constellation of factors. Social-behavioral science research has focused on creating frameworks that identify which contextual, personal, social, or drug-related factors appear to most influence adherence. Comprehensive models of adherence propose specific structural relationships between these factors that can be used to plan for, implement, and monitor programs that seek to optimize adherence. The use of social-behavioral models offers multiple advantages in both practice and research environments; however, the breadth and depth of these models can deter many from engaging in this important exercise. To promote the use of social-behavioral frameworks and models of adherence, we provide a brief overview of the advantages in using a social-behavioral lens in adherence work, a sampling of models used in HIV medication adherence research that have high generalizability to other conditions, and practical guidance for grounding adherence promotion strategies in evidence informed by social-behavioral science research.


social-behavioral models health behavior adherence models medication adherence HIV 



Dr. Bosworth was supported in part by a VA Health Services Research and Development Senior Career Scientist award (VA HSRD 08-027). Dr. Merlin is supported by Agency for Healthcare Research and Quality grant K23MH104073. The authors would like to thank the UAB “Understanding and Improving Treatment Adherence: An Interdisciplinary Approach” conference leaders, as well as Elizabeth Rahn, PhD, for their review and input in the preparation of this manuscript, and Stacey C. Tobin, PhD, for providing editorial support.

Compliance with Ethical Standards

Conflict of Interest

Dr. Amico has received an education grant from Gilead Sciences through the University of Michigan. Dr. Bosworth has received consulting funds from Genentech, Sanofi, and Boehringer Ingelheim. Dr. Bosworth has also received grant funding from Sanofi, Johnson & Johnson, Takeda, and Improved Patient Outcomes. All other authors declare that they have no conflict of interest.


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Copyright information

© Society of General Internal Medicine 2017

Authors and Affiliations

  • K. Rivet Amico
    • 1
  • M. Mugavero
    • 2
  • Marie A. Krousel-Wood
    • 3
  • Hayden B. Bosworth
    • 4
  • Jessica S. Merlin
    • 2
  1. 1.University of Michigan, School of Public HealthAnn ArborUSA
  2. 2.Division of Infectious Diseases, Department of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Tulane University Schools of Medicine and Public Health and Tropical Medicine and Ochsner Health SystemNew OrleansUSA
  4. 4.Center for Health Services Research in Primary Care, Durham VAMCDuke University Medical CenterDurhamUSA

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