The Medication Adherence Model: a guide for assessing medication taking.

The Medication Adherence Model (MAM) was developed to describe the process of medication adherence and guide health care providers in assessing medication-taking in individuals with hypertension. The MAM was structured with the idea that two types of nonadherence contribute to inconsistent medication taking, the intentional decision to miss medications, and the unintentional interruptions that cause medications not to be taken. The three core concepts identified in the model are: (a) Purposeful Action, (b) Patterned Behavior, and (c) Feedback. Patients' initiating and sustaining medication adherence are dependent on the deliberate decision to take medications based on perceived need, effectiveness, and safety (Purposeful Action). Then they establish medication-taking patterns through access, routines, and remembering (Patterned Behavior). Individuals use information, prompts, or events (Feedback) during the appraisal process to evaluate health treatment that, in return, influences individuals' levels of Purposeful Action and Patterned Behavior (Johnson, 2002; Johnson, Williams, & Marshall, 1999). The MAM depicts the dynamic process of initiating and maintaining medication adherence from the hypertensive patient's perspective. The model describes the key components of existing cognitive and self-regulatory models, and identifies an additional behavioral component. The succinct organization of the MAM may facilitate health care providers' ability to evaluate and individualize interventions for promoting medication taking.