The Necessity Concerns Framework (NCF)™
Patients’ motivation to start and continue with prescribed medication is influenced by the way in which they judge their personal need for medication (necessity beliefs), relative to their concerns about potential adverse effects. Studies spanning long-term conditions show that non-adherence is related to doubts about personal need for the treatment and concerns about the potential adverse consequences of using it as advised.
Medication Necessity Beliefs
To arrive at a necessity belief, we ask the question ‘How much do I need this treatment?’ Perceived necessity is not a form of efficacy belief. We might believe that a treatment will be effective but not that we need it. Necessity beliefs are influenced by perceptions of the condition being treated as well as by symptom expectations and experiences.
One obvious source of concern is the experience of symptoms as medication ‘side effects’ and the disruptive effects of medication on daily living; but this is not the whole picture. Many patients receiving regular medication who have not experienced adverse effects are still worried about possible problems in the future.
The NCF™ enables us to segment patient cohorts and show a correlation between patient beliefs and adherence.