Open Access Open Badges Correspondence

Furthering patient adherence: A position paper of the international expert forum on patient adherence based on an internet forum discussion

Sandra van Dulmen1*, Emmy Sluijs1, Liset van Dijk1, Denise de Ridder2, Rob Heerdink3, Jozien Bensing12 and the International Expert Forum on Patient Adherence

Author Affiliations

1 NIVEL (Netherlands Institute for Health Services Research), PO box 1568, 3500 BN Utrecht, The Netherlands

2 Utrecht University, Department of Psychology and Health, PO box 80140, 3508 TC Utrecht, The Netherlands

3 Utrecht University, Department of Pharmacoepidemiology & Pharmacotherapy, PO box 80082, 3508 TB Utrecht, The Netherlands

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BMC Health Services Research 2008, 8:47  doi:10.1186/1472-6963-8-47

Published: 27 February 2008



As the problem of patient non-adherence persists and a solution appears hard to be found, it continues to be important to look for new ways to further the issue. We recently conducted a meta-review of adherence intervention studies which yielded a preliminary agenda for future research, practice and theory development in patient adherence. The objective of the present project was to find out to what extent adherence experts consider this agenda relevant and feasible.


The thirty-five corresponding authors of the review studies included in the meta-review were invited to join the International Expert Forum on Patient Adherence and to participate in a four-week web-based focus group discussion. The discussion was triggered by the points on the preliminary agenda presented as propositions to which forum members could react. Two researchers analysed the transcripts and selected relevant phrases.


Twenty adherence experts participated. Various ideas and viewpoints were raised. After the closure of the web-site, the expert forum was asked to authorize the synthesis of the discussion, to list the propositions in order of priority and to answer a few questions on the use of the web-based focus group as a tool to obtain expert opinions. Their ranking showed that the development of simple interventions is the most promising step to take in fostering patient adherence, preferably within a multidisciplinary setting of medical, pharmaceutical, social and technical science and, not in the least, by incorporating patients' perspectives.


For enhancing adherence, the development of simple interventions originating from a multidisciplinary perspective including patients' input, appears most promising. Disclosing patients' perspectives requires open communication about patients' expectations, needs and experiences in taking medication and about what might help them to become and remain adherent.