Evidence for Change

Evidence for Change provides a quick, evidence-based overview of key behavioral science research that Atlantis Health applies in supporting patients to achieve optimal health outcomes.

Dr Kate Perry is the Group Behavioral Science Director at Atlantis Health, bringing the latest evidence-based interventional approaches in developing and building optimized patient support solutions that empower people living with long-term conditions to create Change for Good.

Research selected

Intentional nonadherence to self-administered cancer medications: Identifying key factors for tailored interventions” Perry, K., Choi, J., Weinman, J., & Petrie, K. J. (2026). Journal of Psychosomatic Research, 204, 112582.

Relevance today

The challenge of intentional nonadherence

Even with advances in oncology treatments, intentional nonadherence continues to undermine optimal patient outcomes.

Unlike unintentional nonadherence—such as missed doses, access barriers, or financial challenges—intentional nonadherence reflects a conscious decision by patients to modify, delay, or stop treatment.

These decisions are shaped by personal beliefs, concerns, and real-world experiences of therapy.

Traditional adherence programs, which often focus on reminders, access support, or co-pay assistance, are designed to address practical barriers.

While valuable, they rarely address the deeper behavioral drivers that shape intentional treatment decisions, leaving a critical gap in patient support.

Reasons uncovered in our research

Atlantis Health’s global online survey of 126 adults with cancer, most taking self-administered (primarily oral) treatments, found that 56% of participants reported nonadherence. This relatively high rate likely reflects the survey’s anonymity, which encourages honest reporting of behavior patients may not disclose in clinical settings.

Using the Intentional Non-Adherence Scale (INAS), the study identified four key behavioral drivers:

 

Sensitivity to medicines

Concerns about side effects or potential harm from treatment

Testing treatment

Adjusting doses to see whether treatment is truly necessary

Inconvenience

Perceiving treatment as disruptive or difficult to integrate into daily life

Resisting illness and medication

Avoiding treatment as a way of asserting control or pushing back against illness

These drivers are consistent with patterns observed across other long-term conditions, highlighting a robust, cross-therapeutic behavioral framework.

Understanding these drivers enables early identification of at-risk patients and supports tailored interventions that reflect their psychological and behavioral realities.

Applying the research to address nonadherence

The evidence is clear:

Supporting adherence in oncology requires more than a one-size-fits-all approach.

Atlantis Health has developed a behavioral framework to identify the drivers influencing treatment decisions and help patients stay engaged in ways that align with their values and lived experience.

Grounded in Acceptance and Commitment Therapy (ACT), an evidence-based approach well suited to addressing intentional nonadherence, the framework helps patients navigate the emotional, cognitive, and practical challenges of long-term treatment while staying connected to what matters most. Growing research supports ACT’s use in oncology populations, demonstrating its ability to help patients adapt and maintain engagement with treatment over time.

Contact us to learn more

Behavioral science-led strategies and insights deliver more relevant, acceptable, and effective patient engagement solutions.

This research led to the development of the Atlantis Health behavioral framework for oncology, which identifies cancer patients’ behavioral drivers and delivers support that aligns with their values, priorities, and everyday lives.

Working with patients, pharma, healthcare, and life sciences organizations, we co-design and deliver personalized behavior change solutions across multiple channels.

To explore how this research and the Atlantis Health behavioral framework can be applied to support your patients and commercial objectives, contact our Director of Behavioral Science, Dr Kate Perry.