Patient-Centered Care Models and Treatment Adherence in Chronic Diseases

Abstract

This study examines how patient-centered care models influence treatment adherence among individuals with chronic diseases. Chronic diseases such as diabetes, cardiovascular disease, chronic respiratory conditions, and hypertension present persistent treatment challenges that require long-term patient engagement with care plans. Treatment adherence, defined as the extent to which a patient follows prescribed medical regimens, medication schedules, lifestyle adjustments, and therapeutic recommendations, profoundly affects health outcomes, quality of life, and healthcare costs (World Health Organization, 2003). Patient-centered care emphasizes tailoring healthcare delivery to individual patient needs, values, preferences, and active engagement in decision making (Institute of Medicine, 2001). Core elements of patient-centered care include shared decision making, comprehensive communication, emotional support, care coordination, and respect for patient preferences. These elements may foster greater trust, understanding, and empowerment, thereby promoting adherence. Despite theoretical support, empirical evidence about the mechanisms linking patient-centered practices with adherence in chronic illness remains fragmented. Using a quantitative cross-sectional design, this study collected survey data from patients diagnosed with one or more chronic conditions across multiple outpatient clinics. A validated questionnaire measured perceptions of patient-centered care dimensions and self-reported adherence. Structural equation modeling (SEM) via SmartPLS tested relationships between care model constructs and adherence outcomes. Findings reveal that shared decision making (β = 0.34, p < .001), communication quality (β = 0.29, p < .001), and care coordination (β = 0.27, p < .01) each significantly predict higher treatment adherence. Emotional support showed a smaller but still significant effect (β = 0.18, p < .05). The model explained 56 percent of variance in adherence behaviors, suggesting that patient-centered care processes play a meaningful role in supporting chronic disease management. These results reinforce the importance of clinical practices that go beyond biomedical interventions to foster relational, cognitive, and structural support for patients. Implications include training clinicians in effective communication, redesigning care pathways for greater shared decision making, and implementing systems that support coordinated care. Challenges include measuring adherence objectively and ensuring representativeness across diverse populations. Future research should explore longitudinal effects and intervention studies that build patient agency and integrate behavioral support mechanisms. Investing in patient-centered systems not only aligns with ethical care principles but also offers practical pathways to improved adherence and better chronic disease outcomes