Motivational reminder model for medication adherence : an internalization approach

• Main Author: Zhang, Yaming
• Other Authors: Miao Chun Yan
• Format: Thesis-Master by Research
• Language: English
• Published: Nanyang Technological University 2022
• Subjects: Engineering::Computer science and engineering
• Online Access: https://hdl.handle.net/10356/154950
• Institution: Nanyang Technological University

Resolving the issue of medication non-adherence is a top priority in order to tackle chronic diseases effectively. State-of-the-art solutions for patients typically focus on medication reminders, which did not address the issue for those who intentionally do not adhere to their medications. At the heart of medication adherence is motivation; self-initiated healthy behaviours tend to generate long-lasting healthy effects alongside desired satisfaction. The challenge therefore lies in motivating individuals to adhere to their medication schedules. This thesis proposes a utilization of Self-Determination Theory (SDT) to design a Motivational Reminder Model (MRM). The model builds on the well-established stages of internalizing new behaviour, a process documented in detail in the Organismic Integration Theory (OIT, a sub theory of SDT). Design approaches are proposed and then used to craft motivational reminders for each internalization stage. The motivational messages in reminders aim to facilitate individuals’ transition to subsequent internalization stages. Through the concept of stages, the proposed motivational reminder takes a goal-oriented approach in facilitating the internalization process of healthy behaviour by introducing various forms of motivation at different stages, ranging from extrinsic motivation to self-determined motivation. Delivered through reminders, these messages aim to curb both unintentional and intentional cases of medication non-adherence. Two studies are conducted to enhance and validate the motivational reminder model. Study I presents a secondary analysis which displayed evidence that supports the importance of extrinsic regulation, the first stage of internalization process. The secondary analysis results also uncover key insights for designing motivational reminders to be tested in study II. In study II, the effectiveness of the designed motivational reminders is evaluated, in terms of improving adherence rate, increasing self-determination and shifting individuals to the more autonomous side of the internalization continuum. Study results conclude that the implemented motivational reminders according to the proposed model is effective in facilitating internalization which leads to improved adherence. In short, the proposed MRM can be used to generate effective motivational reminder messages. In addition, studies presented in this thesis show promising results that support MRM’s effectiveness in encouraging behaviour change through the internalization process.