either underpowered, methodologically flawed, or with too short follow up periods to – demonstrate an improvement in clinical outcome. Studies have shown that direct medication reminders are effective at improving adherence rates, but have also failed to show an improvement in clinical outcome. 2.16 - Evidence Deficit The literature review has shown there have been no studies in either children or adults, with asthma or CF which have demonstrated an effective and clinically feasible adherence intervention, which has achieved a significant and sustained improvement in adherence and clinical outcomes. Previous studies have either been underpowered, or had methodological flaws when measuring adherence rates which have potentially reduced the validity of their results. 2.17 - Research Hypothesis 2.17.1 Adherence Conceptual Framework As demonstrated in the review of literature, non-adherence is likely to be a combination of intentional and non-intentional factors, and in order to improve adherence, both factors need to be addressed. Previous interventions have potentially failed because they have only addressed one of these factors. In order for a patient to achieve full adherence, they and their parents need to have a positive view of asthma/ CF and inhaled medication, and have the capability and opportunity to take the medication regularly. Once this has been achieved, the regular behaviour of taking medication can become a habit, and on-going adherence will be more routine. Based on this premise, a conceptual framework for adherence and habit formation has been proposed by Martin Wildman and colleagues,
either underpowered, methodologically flawed, or with too short follow – up periods to demonstrate an improvement in clinical outcome. Studies have shown that direct medication reminders are effective at improving adherence rates, but have also failed to show an improvement in clinical outcome. 2.16 - Evidence Deficit The literature review has shown there have been no studies in either children or adults, with asthma or CF which have demonstrated an effective and clinically feasible adherence intervention, which has achieved a significant and sustained improvement in adherence and clinical outcomes. Previous studies have either been underpowered, or had methodological flaws when measuring adherence rates which have potentially reduced the validity of their results. 2.17 - Research Hypothesis 2.17.1 Adherence Conceptual Framework As demonstrated in the review of literature, non-adherence is likely to be a combination of intentional and non-intentional factors, and in order to improve adherence, both factors need to be addressed. Previous interventions have potentially failed because they have only addressed one of these factors. In order for a patient to achieve full adherence, they and their parents need to have a positive view of asthma/ CF and inhaled medication, and have the capability and opportunity to take the medication regularly. Once this has been achieved, the regular behaviour of taking medication can become a habit, and on-going adherence will be more routine. Based on this premise, a conceptual framework for adherence and habit formation has been proposed by Martin Wildman and colleagues,
Rob_Morton_Thesis_Submission_December_2017.docx