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Appendix A: Articles used in Meta-analysis 1. Alogna M. Perception of severity of disease and health locus of control in compliant and noncompliant diabetic patients. Diabetes Care. 1980;3:533-534. 2. Anson O, Weizman Z, Zeevi N. Celiac disease: parental knowledge and attitudes of dietary compliance. Pediatrics. 1990;85:98-103. 3. Apter AJ, Boston RC, George M, et al. Modifiable barriers to adherence to inhaled steroids among adults with asthma: it's not just black and white. J Allergy Clin Immunol. 2003;111:1219-1226. 4. Apter AJ, Reisine ST, Affleck G, et al. Adherence with twice-daily dosing of inhaled steroids. Socioeconomic and health-belief differences. Am J Respir Crit Care Med. 1998;157:1810-1817. 5. Ascione L, Accietto C, Acanfora D, et al. [Prognostic value of systolic time intervals in patients with ischemic cardiopathy]. Minerva Cardioangiol. 1985;33:425-430. 6. Avorn J, Monette J, Lacour A, et al. Persistence of use of lipid-lowering medications: a cross-national study. JAMA. 1998;279:1458-1462. 7. Baines CJ, To T, Wall C. Women's attitudes to screening after participation in the National Breast Screening Study. A questionnaire survey. Cancer. 1990;65:1663-1669. 8. Balkrishnan R, Christensen DB, Bowton DL. Self-reported health status, prophylactic medication use, and healthcare costs in older adults with asthma. J Am Geriatr Soc. 2002;50:924-929. 9. Barr RG, Somers SC, Speizer FE, et al. Patient factors and medication guideline adherence among older women with asthma. Arch Intern Med. 2002;162:1761-1768. 10. Bauman LJ, Wright E, Leickly FE, et al. Relationship of adherence to pediatric asthma morbidity among inner-city children. Pediatrics. 2002;110:e6. 11. Becker MH, Drachman RH, Kirscht JP. Predicting mothers' compliance with pediatric medical regimens. J Pediatr. 1972;81:843-854. 12. Becker MH, Radius SM, Rosenstock IM, et al. Compliance with a medical regimen for asthma: a test of the health belief model. Public Health Rep. 1978;93:268-277. 13. Bigby JA, Pappius E, Cook EF, et al. Medical consequences of missed appointments. Arch Intern Med. 1984;144:1163-1166. 14. Borowitz D, Wegman T, Harris M. Preventive care for patients with chronic illness. Multivitamin use in patients with cystic fibrosis. Clin Pediatr (Phila). 1994;33:720-725. 15. Brand FN, Smith RT, Brand PA. Effect of economic barriers to medical care on patients' noncompliance. Public Health Rep. 1977;92:72-78. 16. Brownbridge B, Fielding D. An investigation of psychological factors influencing adherence to medical regime in children and adolescents undergoing haemodialysis and capd. Journal of Adolescent Medicine and Health. 1989;4:7-18. 17. Buchwald D, Sheffield J, Furman R, et al. Influenza and pneumococcal vaccination among Native American elders in a primary care practice. Arch Intern Med. 2000;160:1443-1448. 18. Cardin VA, Grimes RM, Jiang ZD, et al. Low-income minority women at risk for cervical cancer: a process to improve adherence to follow-up recommendations. Public Health Rep. 2001;116:608-616. 19. Carney PA, Harwood BG, Weiss JE, et al. Factors associated with interval adherence to mammography screening in a population-based sample of New Hampshire women. Cancer. 2002;95:219-227. 20. Carney RM, Freedland KE, Eisen SA, et al. Adherence to a prophylactic medication regimen in patients with symptomatic versus asymptomatic ischemic heart disease. Behav Med. 1998;24:35-39. 21. Carpenter JO, Davis LJ. Medical recommendations--followed or ignored? Factors influencing compliance in arthritis. Arch Phys Med Rehabil. 1976;57:241246. 22. Castellano PZ, Wenger NK, Graves WL. Adherence to screening guidelines for breast and cervical cancer in postmenopausal women with coronary heart disease: an ancillary study of volunteers for hers. J Womens Health Gend Based Med. 2001;10:451-461. 23. Catz SL, Heckman TG, Kochman A, et al. Rates and correlates of HIV treatment adherence among late middle-aged and older adults living with HIV disease. Psychology, Health and Medicine. 2001;6:47-58. 24. Catz SL, Kelly JA, Bogart LM, et al. Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychol. 2000;19:124-133. 25. Cerkoney KA, Hart LK. The relationship between the health belief model and compliance of persons with diabetes mellitus. Diabetes Care. 1980;3:594-598. 26. Chambers CV, Markson L, Diamond JJ, et al. Health beliefs and compliance with inhaled corticosteroids by asthmatic patients in primary care practices. Respir Med. 1999;93:88-94. 27. Charney E, Bynum R, Eldredge D, et al. How well do patients take oral penicillin? A collaborative study in private practice. Pediatrics. 1967;40:188-195. 28. Cheng NG, Browne GJ, Lam LT, et al. Spacer compliance after discharge following a mild to moderate asthma attack. Arch Dis Child. 2002;87:302-5. 29. Christiaanse ME, Lavigne JV, Lerner CV. Psychosocial aspects of compliance in children and adolescents with asthma. J Dev Behav Pediatr. 1989;10:7580. 30. Ciechanowski PS, Katon WJ, Russo JE. Depression and diabetes: impact of depressive symptoms on adherence, function, and costs. Arch Intern Med. 2000;160:3278-3285. 31. Cockburn J, Gibberd RW, Reid AL, et al. Determinants of non-compliance with short term antibiotic regimens. Br Med J (Clin Res Ed). 1987;295:814-818. 32. Cole RP, Palushock S, Haboubi A. Osteoporosis management: physicians' recommendations and womens' compliance following osteoporosis testing. Women Health. 1999;29:101-115. 33. Conway SP, Pond MN, Hamnett T, et al. Compliance with treatment in adult patients with cystic fibrosis. Thorax. 1996;51:29-33. 34. Cummings KM, Kirscht JP, Binder LR, et al. Determinants of drug treatment maintenance among hypertensive persons in inner city Detroit. Public Health Rep. 1982;97:99-106. 35. DiMatteo MR, Sherbourne CD, Hays RD, et al. Physicians' characteristics influence patients' adherence to medical treatment: results from the Medical Outcomes Study. Health Psychol. 1993;12:93-102. 36. Evangelista LS, Berg J, Dracup K. Relationship between psychosocial variables and compliance in patients with heart failure. Heart Lung. 2001;30:294-301. 37. Fink AK, Gurwitz J, Rakowski W, et al. Patient beliefs and tamoxifen discontinuance in older women with estrogen receptor-positive breast cancer. J Clin Oncol. 2004;22:3309-3315. 38. Frank JC, Hirsch SH, Chernoff J et al. Determinants of patient adherence to consultative comprehensive geriatric assessment recommendations. J Gerontol A Biol Sci Med Sci. 1997;52:M44-51. 39. Friend R, Hatchett L, Schneider MS, et al. A comparison of attributions, health beliefs, and negative emotions as predictors of fluid adherence in renal dialysis patients: a prospective analysis. Ann Behav Med. 1997;19:344-347. 40. Gillum RF, Neutra RR, Stason WB, et al. Determinants of dropout rate among hypertensive patients in an urban clinic. J Community Health. 1979;5:94-100. 41. Gordillo V, del Amo J, Soriano V, et al. Sociodemographic and psychological variables influencing adherence to antiretroviral therapy. AIDS. 1999;13:17631769. 42. Grady KL, Jalowiec A. Predictors of compliance with diet 6 months after heart transplantation. Heart Lung. 1995;24:359-368. 43. Grant RW, Devita NG, Singer DE, et al. Polypharmacy and medication adherence in patients with type 2 diabetes. Diabetes Care. 2003;26:1408-1412. 44. Greene JY, Weinberger M, Jerin MJ, et al. Compliance with medication regimens among chronically ill, inner city patients. J Community Health. 1982;7:183-193. 45. Gudas LJ, Koocher GP, Wypij D. Perceptions of medical compliance in children and adolescents with cystic fibrosis. J Dev Behav Pediatr. 1991;12:236242. 46. Hand CH, Bradley C. Health beliefs of adults with asthma: toward an understanding of the difference between symptomatic and preventive use of inhaler treatment. J Asthma. 1996;33:331-338. 47. Harris R, Linn MW. Health beliefs, compliance, and control of diabetes mellitus. South Med J. 1985;78:162-166. 48. Hershey JC, Morton BG, Davis JB, et al. Patient compliance with antihypertensive medication. Am J Public Health. 1980;70:1081-1089. 49. Horne R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 1999;47:555-567. 50. Hulka BS, Cassel JC, Kupper LL, et al. Communication, compliance, and concordance between physicians and patients with prescribed medications. Am J Public Health. 1976;66:847-853. 51. Irwin CE, Jr., Millstein SG, Ellen JM. Appointment-keeping behavior in adolescents: factors associated with follow-up appointment-keeping. Pediatrics. 1993;92:20-23. 52. Jacobson AM, Hauser ST, Wolfsdorf JI, et al. Psychologic predictors of compliance in children with recent onset of diabetes mellitus. J Pediatr. 1987;110: 805-811. 53. Kalichman SC, Ramachandran B, Catz S. Adherence to combination antiretroviral therapies in HIV patients of low health literacy. J Gen Intern Med. 1999;14:267-73. 54. Kavanagh DJ, Gooley S, Wilson PH. Prediction of adherence and control in diabetes. J Behav Med. 1993;16:509-522. 55. Kirscht JP, Rosenstock IM. Patient adherence to antihypertensive medical regimens. J Community Health. 1977;3:115-124. 56. Kouris A, Wahlqvist ML, Worsley A. Characteristics that enhance adherence to high-carbohydrate/high-fiber diets by persons with diabetes. J Am Diet Assoc. 1988;88:1422-1425. 57. Kremers SP, Mesters I, Pladdet IE, et al. Participation in a sigmoidoscopic colorectal cancer screening program: a pilot study. Cancer Epidemiol Biomarkers Prev. 2000;9:1127-1130. 58. Kyngas H. Compliance with health regimens of adolescents with epilepsy. Seizure. 2000;9:598-604. 59. Lahdenpera TS, Wright CC, Kyngas HA. Development of a scale to assess the compliance of hypertensive patients. Int J Nurs Stud. 2003;40:677-684. 60. Laine C, Newschaffer CJ, Zhang D, et al. Adherence to antiretroviral therapy by pregnant women infected with human immunodeficiency virus: a pharmacy claims-based analysis. Obstet Gynecol. 2000;95:167-173. 61. Lane DS. Compliance with referrals from a cancer-screening project. J Fam Pract. 1983;17:811-817. 62. Lannon CM, Earp J. Parents' behavior and attitudes toward screening children for high serum cholesterol levels. Pediatrics. 1992;89:1159-1163. 63. Lee P, Tan LJ. Drug compliance in outpatients with rheumatoid arthritis. Aust N Z J Med. 1979;9:274-277. 64. Lynch DJ, Birk TJ, Weaver MT, et al. Adherence to exercise interventions in the treatment of hypercholesterolemia. J Behav Med. 1992;15:365-377. 65. MacDonald ME, Hagberg KL, Grossman BJ. Social factors in relation to participation in follow-up care of rheumatic fever. The Journal of Pediatrics. 1963;62:503-513. 66. Manzella BA, Brooks CM, Richards JM, Jr. et al. Assessing the use of metered dose inhalers by adults with asthma. J Asthma. 1989;26:223-230. 67. Martinez J, Bell D, Camacho R,et al. Adherence to antiviral drug regimens in HIV-infected adolescent patients engaged in care in a comprehensive adolescent and young adult clinic. J Natl Med Assoc. 2000;92:55-61. 68. Massad LS, Meyer PM. Predicting compliance with follow-up recommendations after colposcopy among indigent urban women. Obstet Gynecol. 1999;94:371-376. 69. McArdle N, Devereux G, Heidarnejad H, et al. Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med. 1999;159:1108-1114. 70. McCarthy BD, Yood MU, Janz NK, et al. Evaluation of factors potentially associated with inadequate follow-up of mammographic abnormalities. Cancer. 1996;77:2070-2076. 71. McClellan WM, Hall WD, Brogan D, et al. Continuity of care in hypertension. An important correlate of blood pressure control among aware hypertensives. Arch Intern Med. 1988;148:525-528. 72. McCrindle BW, O'Neill MB, Cullen-Dean G, et al. Acceptability and compliance with two forms of cholestyramine in the treatment of hypercholesterolemia in children: a randomized, crossover trial. J Pediatr. 1997;130:266-273. 73. McHutchison JG, Manns M, Patel K, et al. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology. 2002;123:1061-1069. 74. McPherson ML, Lairson DR, Smith EO, et al. Noncompliance with medical follow-up after pediatric intensive care. Pediatrics. 2002;109:e94. 75. McQuaid EL, Kopel SJ, Klein RB, et al. Medication adherence in pediatric asthma: reasoning, responsibility, and behavior. J Pediatr Psychol. 2003;28:323333. 76. Meurice JC, Dore P, Paquereau J, et al. Predictive factors of long-term compliance with nasal continuous positive airway pressure treatment in sleep apnea syndrome. Chest. 1994;105:429-433. 77. Meyers A, Dolan TF, Jr., Mueller D. Compliance and self-medication in cystic fibrosis. Am J Dis Child. 1975;129:1011-1013. 78. Miller LG, Liu H, Hays RD, et al. How well do clinicians estimate patients' adherence to combination antiretroviral therapy? J Gen Intern Med. 2002;17:111. 79. Moloney FJ, Almarzouqi E, O'Kelly P, et al. Sunscreen use before and after transplantation and assessment of risk factors associated with skin cancer development in renal transplant recipients. Arch Dermatol. 2005;141:978-982. 80. Munneke M, de Jong Z, Zwinderman AH, et al. Adherence and satisfaction of rheumatoid arthritis patients with a long-term intensive dynamic exercise program (RAPIT program). Arthritis Rheum. 2003;49:665-672. 81. Murphy DA, Belzer M, Durako SJ, et al. Longitudinal antiretroviral adherence among adolescents infected with human immunodeficiency virus. Arch Pediatr Adolesc Med. 2005;159:764-770. 82. Myers RE, Ross E, Jepson C, et al. Modeling adherence to colorectal cancer screening. Prev Med. 1994;23:142-151. 83. Natchiar GN, Thulasiraj RD, Negrel AD, et al. The Madurai Intraocular Lens Study. I: A randomized clinical trial comparing complications and vision outcomes of intracapsular cataract extraction and extracapsular cataract extraction with posterior chamber intraocular lens. Am J Ophthalmol. 1998;125:1-13. 84. Nelson EC, Stason WB, Neutra RR, et al. Impact of patient perceptions on compliance with treatment for hypertension. Med Care. 1978;16:893-906. 85. Nino-Murcia G, McCann CC, Bliwise DL, et al. Compliance and side effects in sleep apnea patients treated with nasal continuous positive airway pressure. West J Med. 1989;150:165-169. 86. Nordstrom BL, Friedman DS, Mozaffari E, et al. Persistence and adherence with topical glaucoma therapy. Am J Ophthalmol. 2005;140:598-606. 87. Opstelten W, Hak E, Verheij TJ, et al. Introducing a pneumococcal vaccine to an existing influenze immunization program: vaccination rates and predictors of noncompliance. Am J Med. 2001;111:474-479. 88. Owen SG, Friesen WT, Roberts MS, et al. Determinants of compliance in rheumatoid arthritic patients assessed in their home environment. Br J Rheumatol. 1985;24:313-320. 89. Palardy N, Greening L, Ott J, et al. Adolescents' health attitudes and adherence to treatment for insulin-dependent diabetes mellitus. J Dev Behav Pediatr. 1998;19:31-37. 90. Paterson DL, Swindells S, Mohr J, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133:2130. 91. Podell RN, Kent D, Keller K. Patient psychological defenses and physician response in the long-term treatment of hypertension. J Fam Pract. 1976;3:145149. 92. Proctor TJ, Mayer TG, Theodore B, et al. Failure to complete a functional restoration program for chronic musculoskeletal disorders: a prospective 1-year outcome study. Arch Phys Med Rehabil. 2005;86:1509-1515. 93. Put C, Van den Bergh O, Demedts M, et al. A study of the relationship among self-reported noncompliance, symptomatology, and psychological variables in patients with asthma. J Asthma. 2000;37:503-510. 94. Rapoff MA, Belmont JM, Lindsley CB, et al. Electronically monitored adherence to medication by newly diagnosed patients with juvenile rheumatoid arthritis. Arthritis Rheum. 2005;53:905-910. 95. Rauscher H, Formanek D, Popp W, et al. Self-reported vs measured compliance with nasal CPAP for obstructive sleep apnea. Chest. 1993;103:1675-1680. 96. Reeves-Hoche MK, Meck R, Zwillich CW. Nasal CPAP: an objective evaluation of patient compliance. Am J Respir Crit Care Med. 1994;149:149-154. 97. Renzi C, Picardi A, Abeni D, et al. Association of dissatisfaction with care and psychiatric morbidity with poor treatment compliance. Arch Dermatol. 2002;138:337-342. 98. Rubenstein LZ, Josephson KR, Nichol-Seamons M, et al. Comprehensive health screening of well elderly adults: an analysis of a community program. J Gerontol. 1986;41:342-352. 99. Samet JH, Libman H, Steger KA, et al. Compliance with zidovudine therapy in patients infected with human immunodeficiency virus, type 1: a crosssectional study in a municipal hospital clinic. Am J Med. 1992;92:495-502. 100. Scarfone RJ, Joffe MD, Wiley JF, 2nd, et al. Noncompliance with scheduled revisits to a pediatric emergency department. Arch Pediatr Adolesc Med. 1996;150:948-953. 101. Schneider J, Kaplan SH, Greenfield S, et al. Better physician-patient relationships are associated with higher reported adherence to antiretroviral therapy in patients with HIV infection. J Gen Intern Med. 2004;19:1096-1103. 102. Schneider MS, Friend R, Whitaker P, et al. Fluid noncompliance and symptomatology in end-stage renal disease: cognitive and emotional variables. Health Psychol. 1991;10:209-215. 103. Schwartz D, Wang M, Zeitz L, et al. Medication errors made by elderly, chronically ill patients. Am J Public Health. 1962;52:2018-2029. 104. Sears CL, Charlson ME. The effectiveness of a consultation. Compliance with initial recommendations. Am J Med. 1983;74:870-876. 105. Sharkness CM, Snow DA. The patient's view of hypertension and compliance. Am J Prev Med. 1992;8:141-146. 106. Sherbourne CD, Hays RD, Ordway L, et al. Antecedents of adherence to medical recommendations: results from the Medical Outcomes Study. J Behav Med. 1992;15:447-468. 107. Sketris I, Waite N, Grobler K, et al. Factors affecting compliance with cyclosporine in adult renal transplant patients. Transplant Proc. 1994;26:2538-2541. 108. Smart N, Haluska B, Jeffriess L, et al. Predictors of a sustained response to exercise training in patients with chronic heart failure: a telemonitoring study. Am Heart J. 2005;150:1240-1247. 109. Solomon DH, Avorn J, Katz JN, et al. Compliance with osteoporosis medications. Arch Intern Med. 2005;165:2414-2419. 110. Spire B, Duran S, Souville M, et al. Adherence to highly active antiretroviral therapies (HAART) in HIV-infected patients: from a predictive to a dynamic approach. Soc Sci Med. 2002;54:1481-1496. 111. Spurrier NJ, Sawyer MG, Staugas R, et al. Association between parental perception of children’s vulnerability to illness and management of children’s asthma. Pediatr Pulmonol. 2000;29:88-93. 112. Thomas EJ, Burstin HR, O’Neil AC, et al. Patient noncompliance with medical advice after the emergency department visit. Ann Emerg Med. 1996;27:4955. 113. Tirrell BE, Hart LK. The relationship of health beliefs and knowledge to exercise compliance in patients after coronary bypass. Heart Lung. 1980;9:487493. 114. Turner J, Wright E, Mendella L, et al. Predictors of patient adherence to long-term home nebulizer therapy for COPD. The IPPB Study Group. Intermittent Positive Pressure Breathing. Chest. 1995;108:394-400. 115. Van Dyke RB, Lee S, Johnson GM, et al. Reported adherence as a determinant of response to highly active antiretroviral therapy in children who have human immunodeficiency virus infection. Pediatrics. 2002;109:e61. 116. Visco AG, Weidner AC, Cundiff GW, et al. Observed patient compliance with a structured outpatient bladder retraining program. Am J Obstet Gynecol. 1999;181:1392-1394. Appendix B: Details of studies used in Meta-analysis Reference Disease Adherence Measure/Regimen Perceptions of Disease Severity Threat N. R Effect adult Size and (a) direction or peds (p) Alogna, 1980 Diabetes Weight loss; blood glucose test/ Adherence to diet Perception of the severity of diabetes 50a +.25 Apter et al., 1998 Asthma Electronic-Chronolog measure/ Adherence to medication (inhaled steroid metered dose ) Belief that asthma is severe and needs treatment 50a +.22 Ascione et al., 1985 Cardio-vascular disease Self-report of doses missed each month; physician's assessment/ Adherence to medication for various cardiovascular diseases Belief that cardiovascular disease needs treatment with drug therapy 181a +.27 Becker et al., 1972 Otitis Media Appointment record/ Adherence to medical appointments Belief that illness is a threat to children 116p +.30 Becker et al., 1978 Asthma Blood levels of thophylline; mothers' report (n's averaged)/ Adherence to medication for asthma Mothers belief that asthma is serious and harmful 109p +.17 I. Perceptions of Disease Severity Threat Cerkoney & Hart, 1980 Diabetes Self-report; direct observation/ Adherence to insulin, urine testing, diet, hypoglycemia management, foot care Perceived severity of Diabetes 30a +.42 Chambers et al., 1999 Asthma Self-report/ Adherence to medication (inhaled corticosteroids) Belief that Asthma is a serious health problem 394a +.08 Cummings et al., 1982 Hypertension Self-report/ Adherence to medication for hypertension Belief that Hypertension is serious 206a +.13 DiMatteo et al., 1993 Cancer control regimens Self-report; serum cotinine/ Adherence to diet, appointments, smoking cessation Belief disease needs treatment 115a +.54 Frank et al., 1997 Various Diagnoses Self-report/ Adherence to recommendations for Comprehensive Geriatric Assessment; beginning self -care recommendations. Belief that medical problem targeted by Comprehensive Geriatric Assessment is serious 139a +.27 Friend et al., 1997 End Stage Renal Disease (ESRD) Weight measurement (interdialytic weight gain)/ Adherence to fluid restriction diet Belief that excess fluid is hazardous for health 39a +.53 Grant et al., 2003 Diabetes Self-report/ Adherence to medication Belief that diabetes needs treatment to prevent future health problems/consequences 128a +.27 Harris & Linn, 1985 Diabetes Self-report; nurse evaluation/ Adherence to diabetes care Diabetes health belief scale: Perceived severity of diabetes 93a +.28 Hershey et al., 1980 Hypertension Self-report/ Adherence to medication Perceived severity of Hypertension 126a +.03 Horne & Weinman, 1999 Asthma, Renal disease, Cardiac disease, Cancer Self-report/ Adherence to medication Belief that illness is serious enough to need treatment. 324a +.21 Irwin et al., 1993 Various diagnoses Medical record/ Adherence to follow up appointment in general adolescent clinic Belief in potentially negative consequences of noncompliance 75p +.30 Kirscht & Rosenstock, 1977 Hypertension Self-report; Pharmacy records/ Adherence to medication and diet (n's averaged) Belief in negative impact of hypertension or sequelae on patient's life. 86a +.18 Kouris et al., 1988 Diabetes Self-report/ Adherence to diet Perceived severity/threat of diabetes 40a +.26 Kremers et al., 2000 Colorectal cancerendoscopic screening Appointment records/ Adherence to appointment for screening Belief in severity of colorectal cancer in comparison with other diseases. 131a +.13 Lynch et al., 1992 Hypercholesterolemia Medical record/ Adherence to exercise Perceived seriousness of hypercholesterolemia 31a +.50 McCrindle et al., 1997 Familial Hypercholesterolemia Pill Count/ Adherence to Medication Belief in seriousness of hypercholesterolemia 38p +.00 Myers et al., 1994 Prevention of Colorectal Cancer Medical record/ Adherence to FOBT test for colorectal cancer (completed and returned) Belief in the severity of colorectal cancer 501a +.08 Opstelten et al., 2001. Vaccination for Influenza and Pneumococal pneumonia Medical record/ Adherence to vaccination recommended by physician Belief that influenza is dangerous 972a +.10 Palardy et al., 1998 Diabetes Self-report; family member report/ Adherence to diabetes self-care Adolescent belief in the severity of not adhering to diabetes care 101p +.21 Samet et al., 1992 HIV Serum and urine levels/ Adherence to medication (zidovudine) Belief that HIV threatens life if not treated 83a +.26 Sharkness et al., 1992 Hypertension Prescription records/ Adherence to medication Belief that hypertension is serious enough to always need treatment 125a +.20 Tirrell & Hart, 1980 Post bypass surgery Self-report/ Adherence to exercise (walking with pulse monitoring) Health belief Model measure- rated severity of disease 30a +.19 Disease Adherence Measure/Regimen Rating Measure of Illness Severity (poor health status) N, adult (a) or peds (p) R Effect Size and directio n Various diagnosis general medical clinic Rheumatoid arthritis Medical record/ Adherence to appointment 130a +.20 54a +.08 Manzella et al., 1989 Asthma 238a +.09 Renzi et al., 2002 Dermatologic problems Health professional report/ Correct use of medication, metered dose inhaler Self-report/ Adherence to medication Physician rating of patient having an unresolved medical problem needing medication Clinical severity rating by examining physician based on disease progression, functional status, prognosis for symptomatic and functional improvement Severity of patient’s asthma rated by MD Dermatologist rated severity of skin lesion 305a +.08 Reference II. Physician Rated Severity (poor health status) Bigby et al., 1984 Carpenter & Davis, 1976 Self-report; report of home health visitor, social worker/ Adherence to exercise Sears & Charlson, 1983 Various Diagnoses Medical record/ Adherence to general medical consultation service recommendations MD (not own physician) rating of severity of the medical condition to be followed up 202a +.26 Carney et al., 1998 Angina Electronic Pill Monitor/ Adherence to medication (low dose aspirin) 62a -.24 Carpenter & Davis, 1976 Rheumatoid Arthritis Self-report; report of home health visitor, social worker/ Adherence to exercise 52a +.14 Catz et al., 2001 HIV Self-report/ Adherence to medication 84a -.25 Cockburn et al., 1987 Various Infections –on treatment with antibiotic Hypertension Pill count/ Adherence to medication Patient report of having angina symptoms, versus silent ischemia with no symptoms Patient assessment of severity of own arthritis based on self evaluation of physical condition, and social and physical limitations due to illness Self reported health, symptoms, fatigue and nausea- on Functional Assessment of HIV Infection Scale Health state index-self report perception of health 195a +.16 Self-rating of own health status 206a +.12 Self-rated seriousness of Illness from medical history questionnaire and self-rated health distress from general health perceptions Self-rated physical functioning and health status---SF-36 Self -rated functional status, degree of difficulty in intermediate activities of daily living 186a -.12 82a -.39 139a -.21 III. Selfrated illness severity (poor health status) Cummings et al., 1982 DiMatteo et al., 1993 Evangelista et al., 2001 Frank et al., 1997 Hypertension, diabetes, heart disease Heart Failure Various Diagnoses Self-report/ Adherence to medication Self-report/ Adherence (general and specific) to exercise and diet Self-report; family member report/ Adherence to medication, diet, exercise Self-report/ Adherence to recommendations for Comprehensive Geriatric Assessment; beginning self -care recommendations. Self-report/ Adherence to diet (low fat) Self-report/ Adherence to medication Grady & Jalowiec, 1995 Greene at al., 1982 Heart transplant Hand & Bradley, 1996 Asthma Medical Record/ Adherence to medication (use of asthma inhaler) Hershey et al., 1985 Jacobson et al., 1987 Kyngäs, 2000 Hypertension Self-report/ Adherence to medication Physician report/ Adherence to diabetes management Self-report/ Adherence to medication, appointments, and management McArdle et al., 1999 Sleep apnea/ hypopnea syndrome Breast Cancer Electronic record/ Adherence to use of CPAP device (hours per night) Medical record/ Adherence to follow-up appointment for abnormal mammogram McClellan et al., 1988 Hypertension Nelson et al., 1978 Opstelten et al., 2001. McCarthy et al., 1996 Self-rating of present health on health perception-rating form Self-report of perceived severity of own illness, rating of own health status Self rated-subjective severity of own asthma 94a -.02 190a -.17 40a +.25 Self rated personal vulnerability to illness Child’s self reported symptoms 128a -.10 50p -.20 Adolescent rates own disease as threatening his/her social and emotional well being, fears complications and seizures of own epilepsy Self-rated sleepiness on Epworth Sleepiness scale 232p -.23 1,103a +.05 Self-report of own general health status 399a -.08 Self-report/ Adherence to appointments Self-report of health status compared with others of the same age 907a +.08 Hypertension Self-report/ Adherence to medication and appointments Self-rated perceived severity of own hypertension 112a + .24 Vaccination for Influenza and Pneumococal Medical record/ Adherence to vaccination advised by physician Self- rated health status 151a -.09 Various chonic illnesses Diabetes Epilepsy pneumonia Renzi et al., 2002 b Rubenstein et al., 1986 Schneider et al., 2004 Sharkness et al., 1992 Sherbourne et al., 1992 Dermatologicpro blems Positive result on compre-hensive health screening for elderly HIV Self-report/ Adherence to medication Self-report/ Adherence to referral appointment Self-rated symptoms/quality of life because of physical symptoms Self-rated seriousness of own medical problem identified as needing follow-up 403a -.16 113a +.33 Self-report/ Adherence to medication 552a -.12 Hypertension Pharmacy record/ Adherence to medication Self-report/ Adherence to medication Self-rated physical health status of HIV including costs, services, and utilization Self reported symptoms of hypertension Self rated physical role functioning 125a +.13 1198a -.19 Self-report/ Adherence to medication Self-report/ Adherence to medication Self rated health status; perception of own health Self rated health status at baseline 353a .00 445a -.05 Parent-rated severity of child's disease, and celiac disease seen as source of difficulty in child’s future Mother’s rating of severity of child's present illness 43p +.29 116 p +.38 Perceived seriousness of child’s asthma condition 109 p +.24 Sketris et al., 1994 Hypertension, diabetes, heart disease Renal transplant Spire et al., 2002 HIV IV. Parent Rated Illness Severity (poor health status) Anson et al., 1990 Celiac disease Physician report based on tests/ Adherence to diet Becker et al., 1972 Otitis Media Becker et al., 1978 Asthma Urine assay; appt. records/ Medication (antibiotic) and follow-up appointment Blood test; mother's report/ Adherence to medication for asthma (n's Charney et al., 1967 Pharyngitis and otitis media Christiaanse et al., 1989 Gudas et al., 1991 Asthma Jacobson et al., 1987 Lannon & Earp, 1992 Diabetes Elevated Cholesterol first screening averaged) Urine assay/ Adherence to medication (full course of antibiotic) Blood test/ Adherence to medication Self-report; other report, physician report/ Adherence to medication (antibiotics), vitamins, enzymes, diet, chest therapy Physician-rating/ Adherence to diabetes management Medical record/ Adherence to follow-up appointment for confirmatory lipid panel Scarfone et al., 1996 Various Diagnoses Medical record/ Adherence to appointment Schneider et al., 1991 End Stage Renal Disease (ESRD) Spurrier et al., 2000 Asthma Reference IV. Objective Measure of Disease Severity Cystic fibrosis Disease Mother's estimate of severity of child’s disease 459p +.10 Parent-rated seriousness of child’s asthma Parent-rated severity of child’s illness 38p .00 100p -.15 Parent rating of child‘s symptoms 50p -.44 Parent rating of child’s health status, poor resistance to illness, past history of serious illness, likelihood of high cholesterol Parent-rated seriousness of child’s illness 134p +.17 174p +.26 Weight measurement (interdialytic weight gain)/ Adherence to fluid restriction, diet Self-report/ Adherence to medication Parent-rated somatic symptoms distress and discomfort. 50p -.18 Parent-rated vulnerability of child to medical illness 101 p +.20 Adherence Measure/Regimen Objective Measure of Disease Severity N. adult (a) or peds (p) R Effect Size and directio n Apter et al., 1998 Asthma Chronolog electronic monitor/ Adherence to medication (inhaled steroids) 50a +.33 85a -.10 Self-rating; Physician assessment/ Adherence to medication Severity of asthma: hospitalizations, ICU visits, fluctuations in the disease, FEV 1 Baseline symptoms, hospitalization, intubation, emergency room visits, disease activity, and functional ability Total number of cardiovascular disease conditions suffered Apter et al., 2003 Asthma Chronolog electronic monitor/ Adherence to medication (inhaled steroids) Ascione et al., 1985 Cariovascular disease 181a -.18 Avorn et al., 1998 Hypertension, Coronary Artery Disease, Diabetes Pharmacy records/ Adherence to medication Markers for coronary artery disease: co-morbid hypertension, diabetes 7,287a +.03 Baines et al., 1990 Breast Cancer Screening Self report/ Breast cancer screening 64,619a +.02 Balkrishnan et al., 2002 Asthma Pharmacy records/ Medication (inhaled steroids) 129a -.14 Barr et al., 2002 Asthma Self-report/ Adherence to medication 5107a -.02 Bauman et al., 2002 Asthma 1,199p -.09 Borowitz et al., 1994 Cystic fibrosis -.43 Cardio-vascular, diabetes, stroke, rheumatoid arthritis Severity of disease measured by FVC. Severity of present illness: Cardiovascular- NY Heart association classification; stroke severity determined by monoparesis or monoplegia; rheumatoid arthritis severity determined by criteria of 80p Brand et al., 1977 Self-report (parents)/ Adherence to medication and prevention of allergen exposure Self-report/ Adherence to vitamins Self-report/ Adherence to medication and health behavior change Family history of breast cancer; number of first degree relatives with breast cancer Severity of Co-Morbidity: Modification of Charlson severityof-comorbidity index based on ICD9 codes Severity of Asthma according to NAEPP guidelines, and presence of co-morbid conditions Severity of morbidity from asthma score 225a -.21 Brownbridge & Fielding, 1989 End Stage Renal Disease (ESRD) Self-report/ Adherence to diet, fluid restriction, peritoneal dialysis Buchwald et al., 2000 Medical record/ Adherence to immunizations Cardin et al., 2001 Influenza and Pneumococcal Vaccination-elders Cervical cancer Carney et al., 2002 Breast Cancer Castellano et al., 2001 Sample has Coronary Heart Disease -screening for gynecologic cancer HIV Catz et al., 2000 Chambers et al., 1999 Asthma Cheng et al., 2002 Asthma Ciechanowski et al., 2000 Diabetes Arthritis and Rheumatism foundation; cancer severity based on type; diabetes severity determined by insulin dose. Co-morbid conditions, in addition to ESRD. 32p -.46 Co-morbid conditions: Existing health problems, chart review for cardiovascular disease, pulmonary disease, diabetes mellitus. Severity of abnormality of cervical cytology; measure of atypical nature of cervical cells. Severity of risk: family history of breast cancer first degree relatives Presence of a serious gynecologic abnormality 550a +.10 1,216a +.15 323a +.07 116a -.09 Self-report/ Adherence to medication Self-report/ Adherence to medication (inhaled corticosteroids) Viral load 72a -.27 Hospitalization for asthma in the past 12 months 394a +.08 Self-report (parent)/ Adherence to medication (metered dose inhaler) Self-report/ Adherence to diet, exercise, diabetes selfcare Asthma severity according to National Asthma Campaign guidelines (Sydney) Diabetes severity and medical comorbidity 73p +.16 359a -.12 Medical record/ Adherence to appointment for further screening, treatment Medical record/ Adherence to mammogram Self-report/ Adherence to yearly gynecology examination and mammogram Cole et al., 1999 Osteoporosis Conway et al., 1996 Cystic fibrosis Cummings et al., 1982 Fink et al., 2004 Hypertension Gillum et al., 1979 Hypertension Gordillo et al., 1999 AIDS Grady & Jalowiec, 1995 Heart transplant Hand & Bradley, 1996 Asthma Medical Record/ Adherence to medication (inhaler) Hulka et al, 1976 Diabetes and Congestive Heart Failure Self-report/ Adherence to medication Kalichman et al., 1999 AIDS Self-report/ Adherence to medication (triple retroviral therapy) Kavanagh et al., 1993 Kyngäs, 2000 Diabetes Lahdenperä et al., Hypertension Self-report/ Adherence to diet, exercise, glucose testing Self-report/ Adherence to medication, appointments, health behavior Self-report/ Breast cancer Epilepsy Self-report/ Adherence to medication, vitamin-mineral supplements Self-report; health professional assessment/ Adherence to medication Severity of Bone Marrow Density measurements-risk of fracture 308a +.04 Severity of disease rated according to medical record parameters 80a .00 Self-report/ Adherence to medication Self-report/ Adherence to medication (tamoxifen) Co-morbid heart conditions 205a +.12 Severity of cancer stage -positive lymph nodes 516a -.07 Medical records/ Adherence to appointments Self-report, pill count/ Adherence to medication Self-report/ Adherence to low fat diet Number of co-morbid chronic diagnoses CD4 cell count (200 and over, versus under 200) Severity, number of symptoms (gastrointestinal, neuromuscular, dermatologic). Severity of asthma based on medication and severity-related asthma incidents Duration of disease, number of concurrent medications, and classification of functional impairment CD4 cell count/Viral load Higher cd4 cell counts, more healthy =better adherence, and undetectable viral load more adherent Number of diabetes complications at pre-test Frequency of seizures (daily, weekly, less) 249a +.20 346a -.22 94a -.27 40a .37 357a .00 184a -.12 63a +.08 232p -.23 Blood pressure- systolic, diastolic 96a +.10 2003 Laine et al., 2000 AIDS Lane, 1983 Abnormal Pap and Mammogram Rheumatoid Arthritis Rheumatic fever Lee & Tan, 1979 Macdonald et al., 1963. Martinez et al., 2000 HIV Massad & Meyer, 1999 Cervical Cancer McArdle et al., 1999 Sleep apnea/ hypopnea syndrome Hypertension McClellan et al., 1988 McHutchison et al., 2002 McPherson et al., 2002 Hepatitis C McQuaid et al, 2003 Pediatric Intensive Care, various conditions Asthma Meurice et al., 1994 Sleep Apnea Meyers et al, 1975 Cystic Fibrosis Adherence to medication, exercise, appointments Pharmacy prescription records/ Adherence to medication (antiretroviral) Medical Record/ Adherence to follow-up appointment for abnormal Pap, mammogram Self-report/ Adherence to medication Physician, staff assessment/ Adherence to medication and appointments Medical record; physician assessment/ Adherence to medication, appointments. Medical record/ Adherence to appointment for follow-up after colposcopy Electronic record/ Adherence to use of CPAP device (hours per night) Self-report/ Adherence to appointments Co-morbid chronic medical diseases 549a -.08 Presence of malignancy or premalignancy 612a +.12 Active joint count and pain severity 108a +.19 Comorbid heart disease and rheumatic fever history CD4 cell count and Viral load 123p +.06 23ap -.10 Cytology, colposcopic biopsy results 448a +.11 Apnea-hypopnea index 1,103a +.08 907a -.03 Pharmacy records; patient diary self-report/ Adherence to medication Self-report/ Adherence to appointments (follow-up after hospitalization) History of comorbid conditions (diabetes, heart disease, stroke, cancer, arthritis, mobility limitations); diastolic blood pressure Degree of advancement of liver fibrosis Peak Risk-of-Mortality Score, length of PICU stay, length of hospital stay. 1,180a -.05 105p -.22 Electronic medication monitor; Self-report/ Adherence to medication Asthma morbidity and functional impairment in asthma 106a .00 Electronic record/ Adherence to use of CPAP device (hours per night) Urine assay/ Initial Apnea-Hypopnea Index score 41a +.37 Shwachman Score of severity of 61a -.17 Miller et al., 2002 HIV Moloney et al., 2005 Skin Cancer Prevention -in renal transplant patients pretransplant Rheumatoid Arthritis Munneke et al., 2003 Adherence to medication (antibiotic) Self-report; Pill count; Electronic medication monitor/ Adherence to medication (antiretroviral) Cystic Fibrosis Boston Opportunistic Disease Survival score, CD4 cell count; viral load Self-report/ Adherence to sunscreen use 464a +.06 Previous skin cancer diagnosis 270a -.11 Chart record/ Adherence to exercise sessions for strength, endurance Self-report/ Adherence to regimen described in medical record Medical record/ Adherence to appointment (follow-up) Self Report/ Adherence to medication and appointments Self-report/ Adherence to continued use of CPAP Health claims data/ Adherence to continuous medical treatment Medical record/ Adherence to vaccination recommended by physician Radiographic evidence of severity of joint damage at study baseline 146a -.11 CD4 cell count; Viral load 231p -.11 Visual acuity (in non-surgical eye) 2874 a -.06 Presence of chronic co-morbid conditions requiring medication Respiratory disturbance index and time with low oxygen saturation Diagnosed (confirmed) versus suspected, unconfirmed glaucoma Presence of additional comorbid conditions 142a +.28 139a +.21 5300a +.02 972a .05 RA symptoms: duration of morning stiffness; erythrocyte sedimentation rate measure of inflammation Severity of present illness: number of hospitalizations, emergency room visits for diabetes related 158a +.19 101p -.22 Murphy et al., 2005 HIV infected adolescents Natchiar et al., 1998 Cataracts Nelson et al., 1978 Hypertension Nino-Murcia et al., 1989 Nordstrom et al., 2005 Opstelten et al., 2001 Sleep Apnea Owen et al., 1985 Rheumatoid Arthritis Self-report/ Adherence to medication Palardy et al., 1998 Diabetes Self-report, parent-report/ Adherence to diabetes care activities Glaucoma Vaccination for Influenza and Pneumococal pneumonia Paterson et al., 2000 AIDS Podell et al., 1976 Hypertension Proctor et al., 2005 Musculo-skeletal disorders Put et al., 2000 Asthma Rapoff et al., 2005 Rheumatoid Arthritis Rauscher et al., 1993 complications in past year CD4 cell count and Viral load at baseline. Blood pressure -initial 81a +.01 23a +.08 Pain intensity: Millon Scale 1440a -.08 Asthma Quality of Life Questionnaire: asthma symptoms 85 a .24 Electronic Measurement/ Adherence to Medication Active joints and morning stiffness 48p .31 Sleep Apnea Electronic record/ Adherence to CPAP use 52a +.24 Reeves-Hoche et al., 1994 Sleep apnea 44a +.14 Schwartz et al., 1962 Various chronic illnesses of the elderly Hypertension Electronic record/ Adherence to CPAP device (hours/night; effective mask pressure) Self-report/ Adherence to medication Initial severity of sleep apnea: Apnea-Hypopnea index, and Oxygen saturation Apnea-Hypopnea index Number of co-morbid diagnoses 78a -.15 Number of co-morbid diagnoses; additional medications taken: diabetes, heart failure, angina, TIA, CVA, renal insufficiency. Number of prior rejection episodes. 125a -.09 353a -.12 Ejection Fraction; Bodily Pain 30 a -.15 History of osteoporosis fracture; number of co-morbid conditions 40,002a +.02 CD4 cell count and Viral load 445a +.01 Sharkness & Snow, 1992 Sketris et al., 1994 Renal transplant Smart et al., 2005 Heart failure Solomon et al., 2005 Osteoporosis Spire et al., 2002 HIV Electronic medication monitor/ Adherence to medication Prescription records/ Adherence to medication Medical record/ Adherence to functional restoration treatment program (successful completion) Self-report/ Adherence to medication Pharmacy records/ Adherence to medication Self-report/ Adherence to medication (cyclosporin) Self-report diary; electronic monitor/ Adherence to exercise at appropriate heart rate Pharmacy claims data/ Adherence to medication (filled prescriptions for osteoporosis medication Self-report (general and specific)/ Spurrier et al., 2000 Asthma Thomas et al., 1996 Various Emergency Department visits Chronic Obstructive Pulmonary Disease HIV Turner et al., 1995 Van Dyke et al., 2002 Visco et al., 1999 Urinary Incontinence Adherence to medication Self (parent)-report/ Adherence to regular use of prevention medication Self-report/ Adherence to medication and appointments Electronic record/ Adherence to Intermittent Positive Pressure Breathing (minutes per day of nebulizer use) Health professional assessment; blood assay/ Adherence to medication (antiretroviral) Self-report (diary)/ Adherence to bladder retraining Severity of asthma symptoms 101 p +.17 Urgency score when admitted to the Emergency Room 2315a +.03 Shortness of breath; FEV 1 983a +.14 Viral load -initial 125p -.19 Number of weekly incontinent episodes 123a -.16 Stem and Leaf Displays of Effect Sizes: I. Perceptions of Disease Severity Threat: R Effect Sizes showing Association between Beliefs in Disease Severity Threat and Patient Adherence .5 .4 .3 .2 .1 .0 - 59 4 11 01125667778 033789 00388 II. Physician Rated Disease Severity (poor health status): R Effect Sizes showing Association between Physician Rated Severity (poor health status) and Patient Adherence .2 - 06 .1 .0 - 889 III. Self-rated Disease Severity (poor health status): R Effect Sizes showing Association between Self Rated Severity (poor health status) and Patient Adherence .3 - 4 .2 - 45 .1 .0 -.0 -.1 -.2 -.3 -.4 - 2346 0258 589 022679 01345 1 IV. Parent Rated Disease Severity (poor health status): R Effect Sizes showing Association between Parent Rated Severity (poor health status) and Patient Adherence: .0 - 01122224 -.0 - 114 V. Objective Measure of Disease Severity (poor health status): R Effect Sizes showing Association between Objective Disease Severity (poor health status) and Patient Adherence: .3 .2 .1 .0 -.0 -.1 -.2 -.3 - 2488 01448 001224456799 0001112233456678888 2356788999 001112224556789 1222377 -.4 - 6 -.5 - 0 ---------------------------------------------------