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Author

Rhian Parham

Other affiliations: University College London
Bio: Rhian Parham is an academic researcher from University of London. The author has contributed to research in topics: Bipolar disorder & Patient satisfaction. The author has an hindex of 7, co-authored 8 publications receiving 1260 citations. Previous affiliations of Rhian Parham include University College London.

Papers
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Journal ArticleDOI
02 Dec 2013-PLOS ONE
TL;DR: The Necessity-Concerns Framework is a useful conceptual model for understanding patients’ perspectives on prescribed medicines and could enhance the quality of prescribing by helping clinicians to engage patients in treatment decisions and support optimal adherence to appropriate prescriptions.
Abstract: Patients' beliefs about treatment influence treatment engagement and adherence. The Necessity-Concerns Framework postulates that adherence is influenced by implicit judgements of personal need for the treatment (necessity beliefs) and concerns about the potential adverse consequences of taking it.

855 citations

Journal ArticleDOI
TL;DR: The way in which patients judge their personal need for MT relative to their concerns about MT can be a significant barrier to adherence, and interventions to facilitate optimal adherence to MT for IBD should address such perceptual barriers.
Abstract: Background: Nonadherence has been reported in over 40% of patients taking maintenance therapies (MT) for inflammatory bowel disease (IBD). Studies in other illness groups have shown that nonadherence is related to negative attitudes to treatment. The aim of this study was to assess patients' attitudes to MT for IBD (beliefs about personal need for MT and potential adverse effects) and to identify whether such beliefs are associated with adherence to MT. Methods: A cross-sectional survey was conducted in which 1871 members of the National Association for Colitis and Crohn's Disease (NACC) completed validated questionnaires assessing beliefs about MT and adherence to MT. Results: Low adherence to MT was reported by 29% of participants and was associated with doubts about personal need for MT (odds ratio [OR] = 0.56; 95% confidence interval [CI]: 0.48–0.64; P < 0.001) and concerns about potential adverse effects (OR = 1.66; 95% CI: 1.42–1.94; P < 0.001). Attitudinal analysis showed that while almost half (48%) of the participants were “accepting” of MT (high necessity, low concerns), a large proportion of the sample (42%) were “ambivalent” about MT (high necessity, high concerns), 6% were “sceptical” (low necessity, high concerns) and 4% were “indifferent” (low necessity, low concerns). Compared to those who were “accepting” of MT, participants in all 3 other attitudinal groups were significantly more likely to be nonadherent. Conclusions: The way in which patients judge their personal need for MT relative to their concerns about MT can be a significant barrier to adherence. Interventions to facilitate optimal adherence to MT for IBD should address such perceptual barriers. (Inflamm Bowel Dis 2008)

252 citations

Journal ArticleDOI
TL;DR: The Necessity-Concerns Framework is a useful theoretical model for understanding key attitudes towards medication in bipolar disorders and interventions to facilitate adherence should elicit and address patients' beliefs about medication.

114 citations

Journal ArticleDOI
TL;DR: This study has identified some of the salient beliefs about BD and its treatment that should be elicited and addressed in interventions to facilitate adherence to medication.
Abstract: Patients' perceptions of illness and treatment have been found to predict adherence to medication in many chronic conditions. This has not yet been fully explored in bipolar disorder (BD). The aim was to use a qualitative methodology to explore in depth the beliefs about BD and its treatment that are associated with adherence to medication prescribed for BD.

102 citations

Journal ArticleDOI
TL;DR: Perceived satisfaction with information is low, particularly in relation to possible drug side-effects, and health practitioners need to elicit individuals' information requirements and tailor information to meet their needs, in order to facilitate informed choice and adherence to treatment.

94 citations


Cited by
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Book ChapterDOI
01 Jan 2010

5,842 citations

Journal ArticleDOI
TL;DR: The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder, and recommend strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment.
Abstract: The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change.

989 citations

Journal ArticleDOI
02 Dec 2013-PLOS ONE
TL;DR: The Necessity-Concerns Framework is a useful conceptual model for understanding patients’ perspectives on prescribed medicines and could enhance the quality of prescribing by helping clinicians to engage patients in treatment decisions and support optimal adherence to appropriate prescriptions.
Abstract: Patients' beliefs about treatment influence treatment engagement and adherence. The Necessity-Concerns Framework postulates that adherence is influenced by implicit judgements of personal need for the treatment (necessity beliefs) and concerns about the potential adverse consequences of taking it.

855 citations

Journal ArticleDOI
01 Feb 2012-Chest
TL;DR: Oral anticoagulation is the optimal choice of antithrombotic therapy for patients with AF with ≥1 non‐sex CHA2DS2‐VASc stroke risk factor(s), and stroke prevention (ie, oral antICOagulation therapy) is the next step.

695 citations

Journal ArticleDOI
TL;DR: Suggestions for research advances that can more fully utilize dynamic aspects of the Common-Sense Model of Self-Regulation are provided and have the potential to further advance the CSM’s contribution to medical practice and patients’ self-management of illness.
Abstract: The Common-Sense Model of Self-Regulation (the "Common-Sense Model", CSM) is a widely used theoretical framework that explicates the processes by which patients become aware of a health threat, navigate affective responses to the threat, formulate perceptions of the threat and potential treatment actions, create action plans for addressing the threat, and integrate continuous feedback on action plan efficacy and threat-progression. A description of key aspects of the CSM's history-over 50 years of research and theoretical development-makes clear the model's dynamic underpinnings, characteristics, and assumptions. The current article provides this historical narrative and uses that narrative to highlight dynamic aspects of the model that are often not evaluated or utilized in contemporary CSM-based research. We provide suggestions for research advances that can more fully utilize these dynamic aspects of the CSM and have the potential to further advance the CSM's contribution to medical practice and patients' self-management of illness.

635 citations