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Research ArticleTheory

Adherence Labeling: Understanding the Origins, Limitations, and Ethical Challenges of “Diagnosing” Nonadherence

Sourik Beltrán, Peter F. Cronholm and Stephen J. Bartels
The Annals of Family Medicine May 2025, 23 (3) 255-261; DOI: https://doi.org/10.1370/afm.240358
Sourik Beltrán
1Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
2The Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts
MD, MBE
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  • For correspondence: SBELTRAN@bidmc.harvard.edu
Peter F. Cronholm
3Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania
MD, MSCE
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Stephen J. Bartels
2The Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts
MD, MS
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Article Information

vol. 23 no. 3 255-261
DOI 
https://doi.org/10.1370/afm.240358
PubMed 
40425480

Published By 
The Annals of Family Medicine
Print ISSN 
1544-1709
Online ISSN 
1544-1717
History 
  • Received for publication July 26, 2024
  • Revision received December 7, 2024
  • Accepted for publication January 20, 2025
  • Published online May 27, 2025.

Copyright & Usage 
© 2025 Annals of Family Medicine, Inc.

Author Information

  1. Sourik Beltrán, MD, MBE1,2⇑,
  2. Peter F. Cronholm, MD, MSCE3 and
  3. Stephen J. Bartels, MD, MS2
  1. 1Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  2. 2The Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts
  3. 3Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania
  1. CORRESPONDING AUTHOR: Sourik Beltrán, Beth Israel Deaconess Medical Center, 330 Brookline Ave, W/Span 2, Boston, MA 02215, SBELTRAN{at}bidmc.harvard.edu

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The Annals of Family Medicine: 23 (3)
The Annals of Family Medicine: 23 (3)
Vol. 23, Issue 3
May/June 2025
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Adherence Labeling: Understanding the Origins, Limitations, and Ethical Challenges of “Diagnosing” Nonadherence
Sourik Beltrán, Peter F. Cronholm, Stephen J. Bartels
The Annals of Family Medicine May 2025, 23 (3) 255-261; DOI: 10.1370/afm.240358

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Adherence Labeling: Understanding the Origins, Limitations, and Ethical Challenges of “Diagnosing” Nonadherence
Sourik Beltrán, Peter F. Cronholm, Stephen J. Bartels
The Annals of Family Medicine May 2025, 23 (3) 255-261; DOI: 10.1370/afm.240358
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  • Article
    • Abstract
    • INTRODUCTION
    • UNDERSTANDING ADHERENCE DOCUMENTATION
    • NONADHERENCE AS A DIAGNOSIS
    • NONADHERENCE AS A LABEL
    • CASE DISCUSSION: THE “NONADHERENT” DIABETIC PATIENT
    • CLINICAL IMPLICATIONS AND FUTURE DIRECTIONS
    • Acknowledgments
    • Footnotes
    • References
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Keywords

  • adherence
  • patient noncompliance
  • stigma
  • bias
  • bioethics
  • systemic racism
  • primary care issues: patient-centered care
  • social labels
  • physician-patient relations
  • motivation
  • barriers
  • health behavior
  • social marginalization
  • minority groups
  • vulnerable populations

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