Karen Lutfey--Patient adherence

Provider Assessments of Patient Adherence

In a year-long multi-method ethnographic study of two diabetes clinics, I examined how physicians assess patient adherence with diabetes treatment regimens, and how those assessments pattern medical decision making and health outcomes. Several articles from this study show that the traditional notion that adherence assessment is primarily a matter of “correctly” determining what patients are doing outside of the clinic oversimplifies what appears to be a much broader undertaking wherein physicians are influenced by organizational features of healthcare settings, providers’ understanding of their own roles, and doctor-patient interaction. These adherence assessments have important implications treatment regimens, because patients of high SES are more likely than their low SES counterparts to have sophisticated treatment regimens that help ward off long-term and life-threatening diabetes complications.

Related papers:

Lutfey, Karen and Jeremy Freese. 2005. “Toward Some Fundamentals of Fundamental Causality: Socioeconomic Status and Health in the Routine Clinic Visit for Diabetes.” American Journal of Sociology 110(5): 1326-72.

Lutfey, Karen and Jonathan Ketcham. 2005. “Patient and Provider Assessments of Adherence and the Sources of Disparities: Evidence from Diabetes Care.” Health Services Research 40(6): 1803-17.

Lutfey, Karen. 2005. “On Practices of ‘Good Doctoring’: Reconsidering the Relationship between Provider Roles and Patient Adherence.” Sociology of Health and Illness 27(4): 421-47.

Lutfey, Karen. 2004. “On Assessment, Objectivity, and Interaction: The Case of Compliance with Medical Treatment Regimens.” Social Psychology Quarterly 67(4): 343-68.

Lutfey, Karen. 2003. “The Influence of Clinic Organizational Features on Providers’ Assessments of Patient Compliance with Medical Treatment Regimens.” Research in the Sociology of Health Care 21: 63-83.

Lutfey, Karen and William J. Wishner. 1999. “Beyond ‘Compliance’ is ‘Adherence’: Improving the Prospect of Diabetes Care.” Diabetes Care 22(4): 635-9.