Role of habit in treatment adherence among adults with cystic fibrosis

Abstract

Telephone: 0114 222 4386Word count: 1,099 words 2 ABSTRACT Among adults with CF, medication adherence is low and reasons for low adherence are poorly understood. Our previous exploratory study showed that stronger 'habit' (i.e. automatically experiencing an urge to use a nebuliser) was associated with higher nebuliser adherence. We performed a secondary analysis of pilot trial data (n=61) to replicate the earlier study and determine whether habit-adherence association exists in other cohorts of adults with CF. In this study, high adherers also reported stronger habit compared to low adherers. Habit may be a promising target for self-management interventions.3

Adherence to medication in adults with Cystic Fibrosis: An investigation using objective adherence data and the Theoretical Domains Framework

“…The highest adherers commonly reported that they did their treatments automatically, indicating that it was habitual. This is consistent with recent research showing the importance of automatic motivation habits in adherence (Hoo et al ., ; Phillips, Cohen, Burns, Abrams, & Renninger, ), including evidence that adherence interventions that focus on habit formation are the most effective (Conn & Ruppar, ). Habits mean that adherence requires less cognitive effort (Gardner, de Bruijn, & Lally, ), and this means that habits can be maintained in circumstances that might make treatment taking more challenging (Gardner, ).…”

“…A range of qualitative studies, which have mainly used a thematic approach to analysis, and reviews have attempted to understand the factors influencing adherence to treatment in CF for adolescents and adults (Abbott, Havermans, & Hart, ; Arias‐llorente, García, & Martín, ; Foster et al ., ; George et al ., ; Hogan, Bonney, Brien, Karamy, & Aslani, ; Hoo, Boote, Wildman, Campbell, & Gardner, ; Horky, Sherman, Laura, Polvinen, & Rich, ; Lask, ; Macdonald et al ., ; Pakhale et al ., ; Sawicki, Heller, Demars, & Robinson, ). These have tended to find that adherence to treatment is reported to be influenced by the extent of treatment burden, having the time to do treatment, having a routine, forgetting to do treatment, a person's identity, perceptions of control, and social support.…”

The Impact of the China-Pakistan Economic Corridor on Pakistan’s Federal System

“…Routine has been shown to be advantageous in adherence in CF. Hoo et al 15 found that patients with higher levels of adherence had the highest habit scores, lower median intravenous antibiotic days and a trend towards higher forced expiratory volume in one second compared with those with low adherence. Habit formation is advantageous as it reduces the need for conscious effort.…”

Self-management intervention to reduce pulmonary exacerbations by supporting treatment adherence in adults with cystic fibrosis: a randomised controlled trial

“…Theories of behavioural maintenance 18 predict that supporting people to create habits for treatment, that is, taking treatments in response to specific contextual cues, can help to sustain adherence and to lower perceived treatment burden. 19 We developed a multi-component (complex) self-management intervention to support sustained treatment adherence, 20 incorporating objective adherence measurement, underpinned by behavioural science theory and designed to address gaps in CF care, with extensive input from people with CF. Since exacerbations are disruptive to patient life, they are an important patientcentred outcome and are commonly considered to indicate lung health.…”