Towards a Process View of Adherence

Adherence is vital to the success of medical interventions, yet it is around 50% in the developed world and may be lower in the developing world.Research into non-adherence is generally not supported by theory, but if it is then those theories are usually expectation-value models which do not reach to the point of consumption, only intention.There is therefore a gap in adherence research.Having analysed the limitations of several such models, this paper explores the use of Service-Dominant Logic as a way to understand adherence as a process which reaches right into the act of consumption.Referring to research which used qualitative interviews, it explores the experiences of people in both the developed and developing worlds and confirms that Service-Dominant Logic, extended with the Integrative Framework of Value and Service Ecosystems, can be used to understand people's adherence decisions from the point of need through the consumption decision to the post-consumption assessment of results.It then draws insights into the steps in the process.Finally, it concludes with thoughts on how these insights can be used by pharmaceutical manufacturers to enhance their products to make adherence more likely.