Have you been taking your pills? The adherence-monitoring sequence in the medical interview

Abstract

This paper employs qualitative, sociolinguistic techniques to identify and describe the kinds of conversational strategies that primary care physicians use to assess patient adherence to antihypertensive regimens. Three general approaches are described: indirect inquiry, simple direct questions, and information-intensive inquiry. The strengths and weaknesses inherent in these discourse categories are discussed. Qualitative assessment, coupled with the results of a pilot study investigating the effectiveness of naturally occurring instances of these three general styles, leads to the conclusion that how one asks "Have you been taking your medications?" is consequential for the accurate diagnosis and management of adherence problems.