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Motivating Patients to Become Compliant:
An Illusion or Just Elusive?

Release Date: February 2009
Expiration Date: January 2010

The target audience for this activity is DOs.

Studies in the United States have shown poor adherence to medications causes an estimated 125,000 deaths annually and accounts for 10% to 25% of hospital and nursing home admissions. Over 70% of all prescriptions go unconsumed leading to an estimated $77 billion in excess health care costs annually. But noncompliance to therapy is not limited to medications. It includes failure to keep appointments, follow recommended dietary and lifestyle changes, and other recommended preventative health practices. This makes noncompliance one of the largest concerns facing physicians and our health care system.

The challenge of getting patients to follow a mutually accepted change in health related behavior is daunting but is recognized as a focus area for quality improvement. The costly and preventable effects of chronic disease in areas such as cardiovascular disease are forging new methods to combat this public health issue. This activity addresses patient centered issues associated with noncompliance and focuses on new strategies designed to improve treatment compliance outcomes. Using cardiovascular disease as an example, experts will review current data and illustrate practical examples of innovative techniques to improve treatment compliance outcomes.

At the conclusion of this continuing education activity, participants should be able to:

  • Examine the clinical barriers for osteopathic physicians related to noncompliance to lipid lowering therapy
  • Analyze the latest clinical data from lipid modifying trials and discuss their relevance in reducing global cardiovascular risk
  • Evaluate methods for osteopathic physicians to improve overall compliance to lipid lowering therapies
  • Illustrate how to implement motivational interviewing techniques that will change patient behavior

This educational activity is sponsored by the American Osteopathic Association (AOA). The AOA has designated this on demand web archive CME activity for 1 hour of credit in Category 1B.


Susan Butterworth, PhD, MS
Associate Professor
Oregon Health & Science University
Director of Health Management Services
Oregon Health & Science University
Portland, Oregon

Susan Butterworth has been in the health promotion field for over 20 years. She received her doctoral degree in adult education and training with a cognate in health promotion from Virginia Commonwealth University. Dr. Butterworth’s special area of expertise and research is Motivational Interviewing-based health coaching, and she is a highly-sought presenter, trainer, and consultant on this topic.  Dr. Butterworth currently holds the position of Vice-President for Health Management Services at Health Future and is an associate professor at both the Schools of Medicine and Nursing at Oregon Health & Science University.

Michael Clearfield, DO
Dean, College of Osteopathic Medicine
Touro University
Vallejo, California

Michael Clearfield, DO, is Dean of Touro University College of Osteopathic Medicine in California. He obtained a doctor of osteopathy degree from the Chicago College of Osteopathic Medicine, Midwestern University in Downers Grove, Illinois and completed residencies in internal medicine at Chicago Osteopathic Hospital in Chicago and Metropolitan Hospital in Philadelphia.

Dr. Clearfield's research interests have focused on preventive heart disease, cholesterol management, and metabolism. He has authored many manuscripts and was the co-primary investigator for the Air Force/Texas Coronary Atherosclerosis Prevention Study, which is the largest primary prevention trial done in the United States studying the reduction of cholesterol relative to that of cardiovascular events.  Dr. Clearfield served as chairman of the American Osteopathic Association's Bureau/Council of Research from 2002-2004 and continues to serve on the council. He is also the AOA's representative to the National Cholesterol Education Program. He received the Outstanding Achievement Award from the Chicago College of Osteopathic Medicine in 1995. He also received the 1997 Internist of the Year award from the American College of Osteopathic Internists and currently serves as a member of the Board of Directors for this organization. In both 2003 and 2005, he was acknowledged by his peers as one of the top doctors in internal medicine as reported in Fort Worth Magazine.

To receive 1 hour of credit in Category 1B you must:

  • Review the full content of the activity and answer the post-test questions.
  • Successfully complete the post-test questions with a minimum passing grade of 70% or higher. Note that if you answer any question incorrectly as you go through the activity, you will be prompted to review the content related to that question and answer again without reviewing the content, prior to proceeding in the activity.
  • You will have unlimited opportunities to successfully complete the activity. Your statement of credit will be issued immediately upon successful completion of the post-test questions and submission of the evaluation.

There is no fee for this educational activity.

This activity is supported by an educational grant from Merck Schering-Plough Pharmaceuticals.

It is the policy of the accreditors to insure balance, independence, objectivity, and scientific rigor in all its individually sponsored or jointly sponsored educational activities. All faculty participating in any Merck/Schering-Plough supported activities are expected to disclose to the activity audience any real or apparent conflicts of interest that may have a direct bearing on the subject matter of the continuing education activity. This pertains to relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the presentation topic. The intent of this policy is not to prevent a speaker with a potential conflict of interest from making a presentation. It is merely intended that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It remains for the audience to determine whether the speaker's outside interests may reflect a possible bias in either the exposition or the conclusions presented.

The faculty reported the following financial relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Name of Faculty or Presenter Reported Financial Relationship
Susan Butterworth, PhD, MS No financial interest/relationships with financial interests relating to the topic of this activity
Michael Clearfield, DO Consultant: AstraZeneca, Pfizer
Speakers Bureau: AstraZeneca, Pfizer

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Name of Planner or Manager Reported Financial Relationship
Christine Sacchetti (Impact Education, LLC) No financial interest/relationships with financial interests relating to the topic of this activity

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MAC OS 10.2.8
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* Required to view printable (PDF) version of the lesson.