0903 - Compliance, Self-Management and Behavioural Change Flashcards
What is medical compliance?
The accurate adherence to instructions provided by a professional with the overall expectation of improvement. OR the extent to which the patient’s health behaviour coincides with medical or health advice.
What are some ways to measure compliance?
Self report - inaccurate
Health provider prediction - overestimates
Measure medication use - variation/manipulation
Clinical outcome - other factors can influence
chemical analysis - good but intrusive and expensive
Why must doctors consider possible barriers to treatment compliance?
Measured rates of compliance are poor and may be worse than research suggests
Difficult to measure compliance accurately - better to be pro-active
Many practitioners don’t consider barriers to treatment compliance.
What are some factors that can influence compliance rates?
Can be patient, doctor, or treatment related.
Patient related:
Age - older = more compliant
Sex - F>M compliant (generally)
Level of education - + Education = + compliance (to a point)
Pt Memory and cognitive status - Impaired memory or cognition = less compliant
Depression and Anxiety - KEY - strong predictor of non-compliance
Pt Personality and experimentation
Pt perceptions of disease
Severity of symptoms
Dr Related
Trust in health provider
Patient satisfaction
Communication from health professional
Treatment related
Ease of administration
Side effects
How can behavioural strategies be used to increase compliance rates?
Dr and Pt make joint decisions regarding treatment.
Pt is given responsibility for directing treatment and monitoring compliance
Self-monitoring works through increasing Pt sense of control over their condition and self-efficacy.
Why is doctor-patient communication important in ensuring compliance?
More Pt understands, more likely they are to comply - Dr needs to take sufficient time to present the info, with sufficient clarity (appropriate level and detail) to get the patient on board and ensure they are more likely to comply.
Develop rapport and address the risk factors for non-compliance. Drs need to check that Pt is informed.
