Archive (2016–2006)

Introducing the Adherence Strategy Engineering Framework (ASEF)

Journal: Methods of Information in Medicine
Subtitle: A journal stressing, for more than 50 years, the methodology and scientific fundamentals of organizing, representing and analyzing data, information and knowledge in biomedicine and health care
ISSN: 0026-1270
Issue: 2013 (Vol. 52): Issue 3 2013
Pages: 220-230

Introducing the Adherence Strategy Engineering Framework (ASEF)

Support for Developing Technology-based Self-care Solutions

Original Article

S. Wagner (1), T. S. Toftegaard (1), O. W. Bertelsen (2)

(1) Department of Engineering, Aarhus University, Aarhus, Denmark; (2) Department of Computer Science, Aarhus University, Aarhus, Denmark


Telemedicine, eHealth, self-care, medication adherence, Patient adherence


Background: Patients performing self-care in the unsupervised setting do not always adhere to the instructions they were initially provided with. As a consequence, a patient’s ability to successfully comply with the treatment plan cannot be verified by the treating healthcare professional, possibly resulting in reduced data quality and suboptimal treatment.

Objectives: The aim of this paper is to introduce the Adherence Strategy Engineering Framework (ASEF) as a method for developing novel technology-based adherence strategies to assess and improve patient adherence levels in the unsupervised setting.

Methods: Key concepts related to self-care and adherence were defined, discussed, and implemented as part of the ASEF framework. ASEF was applied to seven self-care case studies, and the perceived usefulness and feasibility of ASEF was evaluated in a questionnaire study by the case study participants. Finally, we reviewed the individual case studies usage of ASEF.

Results: A range of central self-care concepts were defined and the ASEF methodological framework was introduced. ASEF was successfully used in seven case studies with a total of 25 participants. Of these, 16 provided answers in the questionnaire study reporting ASEF as useful and feasible. Case study reviews illustrated the potential of using context-aware technologies to support self-care in the unsupervised setting as well as ASEF’s ability to support this.

Conclusion: Challenges associated with moving healthcare to the unsupervised setting can be overcome by applying novel context-aware technology using the ASEF method. This could lead to better treatment outcomes and reduce healthcare expenditures.

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