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Leveraging information technology (IT) to improve the treatment and support of patients is a widely studied topic in healthcare. For chronic diseases, such as diabetes, the use of information technology is even more important since its effect extends from a clinic environment to patients’ daily life. The purpose of this paper is to investigate the impacts of one widely adopted information technology, the mobile phone, on diabetes treatment, specifically on the complicated process of patients’ health, emotions and compliance.

We leverage a unique longitudinal dataset on diabetes patients’ health status in rural areas of China to study the problem. We also cross-link the dataset with mobile carrier data to further differentiate mobile phone use to phone calls and network use. To address the endogeneity concerns, we apply PSM and a series of instrument variables.

We identify clear evidence that mobile phone use can significantly improve patients’ emotions and compliance, where the effect is generally larger on patients in worse health conditions. While mobile phone calls clearly benefit diabetes patients, we do notice that mobile phone network use has a negative moderating effect with patients’ health condition on improving compliance.

This study not only enriches our theoretical understanding of the role of mobile phones in diabetes management, it also shows the economic benefit of promoting patients’ use of mobile phones, which should be considered by medical care providers and medical policymakers.

The patient healthcare experience is a complex phenomenon, as is encouraging patient compliance with medical advice. To address this multifaceted relationship, the purpose of this paper is to explore the ways resident physicians verbally encourage patient compliance and the relationship between these compliance-seeking strategies and patient satisfaction.

A total of 40 medical interviews between resident physicians and patients were audio-recorded, transcribed, coded, and analysed. Patient questionnaires were also administered and analysed.

It was found that resident physicians used indirect orders most frequently, followed by motivation, persuasion, scheduling, and direct orders. It was also found that female patients received (marginally) more messages than male patients; female residents used more messages with female patients than with male patients; female residents used more persuasion messages with female patients than with male patients; male residents were less likely than female residents to use motivational messages with female patients; and compliance was significantly correlated with expertise satisfaction, overall satisfaction, and communication satisfaction.

This study advances existing research by examining various ways in which residents verbally encourage patient compliance and the relationship between these messages and patient satisfaction. Findings can be used to inform physicians on strategies to encourage patient adherence to medication regimen, appointments, and lifestyle changes.

The purpose of this paper is to deepen the understanding on patient participatory behaviours in co-creation of value drawing from the perspective of self-determination theory (SDT) focussing on motivation in particular.

A model is proposed to suggest the influence of the various motivation types on a patient’s participatory behaviours drawing from SDT. Following survey design approach, data collected from 345 outpatients from a quasi-government health facility in Accra, Ghana are examined through structural equation modelling using SmartPLS (v. 3.2.3).

The findings reveal that patient participatory behaviours are influenced by both controlled and autonomous regulations leading to value attainment. External regulation (a more controlled form of extrinsic motivation) and patient participation in clinical encounters have no significant relationship with a patient’s commitment to compliance with medical instructions. The results reveal patient compliance is largely driven by autonomous regulation as proposed by SDT. However, active patient participation in clinical encounters and commitment to compliance with medical instructions positively and significantly influences perceived value outcomes.

This research provides empirical evidence in support of understanding patient participatory behaviours in healthcare service delivery by testing theoretically grounded hypotheses developed from SDT perspective. The study focussed on outpatients from one quasi-government health facility, which could limit the generalisation of the findings reported.

This study illustrates the need for service providers to understand participant’s needs and motivation during the service encounter. This is essential as the various types of motivation influence the nature of the participation throughout the process, which could help improve on the value outcomes from the service.

This study makes a significant contribution to service literature through the application of SDT to explain patient participatory behaviours in healthcare service delivery, production and value outcomes. From a theoretical perspective, the developed model integrates multiple research disciplines (e.g. SDT, participatory behaviours, and value co-creation) and extends research on patient integration, participation, and compliance.

Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced well-being or poor therapeutic alliance. However, other still neglected factors may also play a role. Further, little is known about whether psychiatric patients without psychosis who are increasingly prescribed neuroleptics differ in terms of medication compliance or about reasons for non-compliance by psychosis patients. As direct questioning is notoriously prone to social desirability biases, we conducted an anonymous survey. After a strict selection process blind to results, 95 psychiatric patients were retained for the final analyses (69 participants with a presumed diagnosis of schizophrenia psychosis, 26 without psychosis). Self-reported neuroleptic non-compliance was more prevalent in psychosis patients than non-psychosis patients. Apart from side effects and illness insight, main reasons for non-compliance in both groups were forgetfulness, distrust in therapist, and no subjective need for treatment. Other notable reasons were stigma and advice of relatives/acquaintances against neuroleptic medication. Gain from illness was a reason for non-compliance in 11-18% of the psychosis patients. Only 9% of all patients reported no side effects and full compliance and at the same time acknowledged that neuroleptics worked well for them. While pills were preferred over depot injections by the majority of patients, depot was judged as an alternative by a substantial subgroup. Although many patients acknowledge the need and benefits of neuroleptic medication, non-compliance was the norm rather than the exception in our samples.

This paper aims to examine how direct-to-consumer advertising (DTCA) in terms of endorser selection and message tonality affect patients' self-efficacy, response efficacy, and compliance.

This study employed a 3 (Endorser: physician, patient, or celebrity)×2 (Tonality: supportive vs threatening) experimental design. Subjects were 1,211 people with diabetes from Germany.

First, the study shows that the interaction between message sender and tonality significantly affects all dependent variables such as self-efficacy, response efficacy, and patient compliance. Second, physicians as endorsers work best when they use unfavorable, threatening arguments. The results are significant for all dependent variables such as self-efficacy, response efficacy, and patient compliance. Most surprisingly, patients judge attitude significantly higher if physicians use threatening instead of supportive argumentation. Third, tonality does not play a dominant role for patients as person-based testimonials. Fourth, a celebrity performs best by using a supportive message. With regard to stimulating health outcome (self-efficacy, response efficacy, and patient compliance) the celebrity has a significant impact in the supportive rather than in the threatening condition.

This is the first empirical study that examines the effects of DTCA in terms of endorser selection and message tonality on patients' self-efficacy, response efficacy, and compliance.

This chapter attempts to clarify the underlying mechanisms of the relationship between socioeconomic status and health outcomes. Former studies of this relationship have largely focused on the materialist predictors of health outcomes, examining variables such as income, access to healthcare, or quality of housing. The current study, by contrast, looks at individuals’ behaviors and attitudes, particularly in relation to physicians, and their impact on the quality of care patients receive. Using data from a sample of 64 hemodialysis patients in a middle-class suburb of Long Island, I examined the effect of comfort and ease with doctors and willingness to engage them on patient compliance. The findings suggest that patients who are more comfortable asking their doctors how they feel, and those that push for more information in general, tend to be more compliant, and therefore enjoy better and more successful patient outcomes.

The major thesis of this article is how social contract theory sheds light on the interaction of structure and agency. A minor thesis is to rebut the conclusions drawn from Stanley Milgram's famous obedience experiments.

The argument rests in large part on an extensive review of authentic, empirical evidence found in studies of medical compliance.

Patient agency is choosing not to comply with medical orders has over the years forced structural changes in the doctor–patient relations. These changes can be understand through the evolution of three kinds of social contract.

One important implication is that non‐compliance can be a relational choice in one's lifeworld.

No other study has brought together Milgram's evidence with the medical compliance literature to demonstrate the integration of agency and structure.

Purpose – To estimate the impact of diabetic drug adherence on hospitalizations, emergency room (ER) visits, and hospital costs.

Methods – It is often difficult to measure the impact of drug adherence on hospitalizations since both adherence and hospitalizations may be correlated with unobservable patient severity. We control for such unobservables using propensity score methods and instrumental variables for adherence such as drug coinsurance levels and direct-to-consumer advertising.

Findings – We find a significant bias due to unobservable severity in that patients with more severe health are more apt to comply with medications. Thus, the relationship between adherence and hospitalization will be underestimated if one does not control for unobservable severity. Overall, we find that increasing diabetic drug adherence from 50% to 100% reduces the hospitalization rate by 23.3% from 15% to 11.5%. ER visits reduce by 46.2% from 17.3% to 9.3%. Although such an increase in adherence increases diabetic drug spending by $776 a year per diabetic, the cost savings for averted hospitalizations and ER visits are $886 per diabetic, a cost offset of $1.14 per $1.00 spent on diabetic drugs.

Originality – Most of the drug cost-offset literature focuses only on the impact of cost-sharing and drug spending on cost-offsets, making it impossible to back-out the empirical impact of actual drug adherence on cost-offsets. In this chapter, we estimate the direct impact of adherence on hospitalizations and costs.

The paper aims to explore the barriers that currently exist to patient‐driven treatment within the field of mental health care and reform.

This study represents action learning research using grounded theory to explore a possible causal basis for recidivism related to non‐compliance with medication. Interviews addressed concerns from the literature around perceived barriers to patient‐driven treatment evidenced by non‐compliance with medically recommended pharmaceutical treatment. Results were correlated to look for emergent themes that were used to form the basis for subsequent interview questions.

An analysis of the resulting emergent themes illustrated the importance of participatory treatment and coaching rather than medically applied paternalistic care, which is seen as encouraging learned helplessness on the part of patients. Similar helplessness was also revealed in clinicians themselves. Patients' awareness of their own needs and demands for more services place clients and the caregivers at odds over appropriate care in an environment of limited resources.

The research was limited to only a small number of interviewees in one institution, all of whom were closely associated with mental illness in various capacities. The grounded theory nature of the research does, however, provide a framework for more research in other institutions to test and further explore some of the findings.

The study demonstrated a reinforcement of Maslow's theory of needs hierarchy. The study illustrated a step‐wise approach to treatment to decrease the rate of failure and recidivism in mental health care. The provision of a stable living environment was viewed as instrumental in improving patients' compliance with pharmaceutical treatment. An action plan was therefore created to initiate the support of a transitional/emergency house by various community groups in partnership with pharmaceutical manufacturing companies.

Recidivism in mental health‐created by non‐compliance in pharmaceutical treatment, is a major issue in Canada's health care system. This study brings to the forefront issues from a number of perspectives in order to form a course of action in response to its findings.

The purpose of this paper is to investigate how one hospital safety coordinator socially constructs a complete environment of care. Specifically, it applies Shotter's “practical author” framework to examine the author‐response interaction between the safety coordinator and other mid‐level supervisors.

Qualitative methodology is employed to examine this authorship. Data include printed materials employees receive upon hire, an observation of an environment of care orientation presentation, and semi‐structured interviews with the safety coordinator and mid‐level supervisors.

The paper reveals how the safety coordinator uses a variety of rhetorical strategies to balance the tensions between mandating compliance with environment of care requirements and facilitating buy‐in to the idea of compliance as a moral and ethical imperative. This creates an ethos among the employees where they feel authorized to go beyond the requirements and act on their own to construct a safer culture.

The paper has multiple practical and theoretical implications that may be useful to health care and other organizations when examining the broader need for a complete, supportive environment where employees not only comply with but actually live and believe in the values of their organizations' cultures. A limitation is that employee perspective and behavior are primarily inferred based on supervisor reports.

The paper extends theory on communication and developing organizational environments and provides practical application possibilities for organizations.