16-11-21 - Common Sense Model of Treatment

Question 1

Learning outcomes

Answer 1

• Evaluate adherence to health care recommendations
• Apply the CSMT to general prescribing and health care interventions
• Understand the main principles of patient treatment beliefs and how they are incorporated into the CSM

Question 2

What are illness beliefs?

Why are illness beliefs important?

What 3 things do illness beliefs allow us to do?

Answer 2

• Illness beliefs are individual and acquired during life and during the course of an illness
• Illness beliefs are important as they provide patients with a framework for coping with and understanding their illness

• Illness beliefs allow us to:

1) Understand how different people make sense of different illnesses
2) Predict health behaviours
3) Change health behaviours

Question 3

What do good treatment outcomes depend on?

Answer 3

• Good treatment outcomes depend on good medical care and self-management
• Self-management relies on appropriate use of medicine by the individual i.e adherence
• Adherence is vital for optimal treatment outcomes

Question 4

What 2 things is appropriate use of medicine by an individual (adherence) dependent on?

What are some major predictors of poor adherence to medication?

Answer 4

1) Ability – e.g misunderstanding, forgetting, physical impairment
2) Motivation – the individual’s personal motivation to adhere to their medication. This can be influenced by treatment beliefs formed by exposure to information or past experiences

Question 5

What are the 2 categories beliefs about prescribed medicine can be grouped into?

What are example of each?

Answer 5

• 2 categories beliefs about prescribed medicine can be grouped into:

1) Necessity – personal need for treatment

• Examples:
• ‘My health depends on this mediicne’
• ‘These medicines protect me from becoming worse’
• ‘Without these medicines I would be very ill’
• Can involve beliefs about efficacy
• Percieved nercessitt determine adherence more than treatment efficacy

2) Concerns – about negative effects of treaetment
• Can be concrete, abstract, relevant acorss a range of disease states and cultures

• Examples:
• Experience of unpleasant side effects
• Disruptive effects of medication on daily living
• Worries that medication could lead to long term effects
• May be specific to a particular clas of medicine:
• ‘Regular use of analgesic (pain-relief) medication will make it less effective in the future

Question 6

What are 4 necessity beliefs that can affect treatment necessity and treatment options?

What are examples of each?

Answer 6

1) Identity
• Symptom experiences and expectations influence treatment necessity
• E.g severity of symptoms and absence of symptoms

2) Cause
• Putative causes (what is widely accepted rather than what is based on actual proof) may influence need for treatment options
• E.g illness believed to be caused from lack of nutrition, so seeking a change in diet instead of taking medication

3) Timeline and consequences
• Perceptions of illness duration and consequences may influence treatment necessity
• Perception of illness as cyclical instead of chronic impacts adherence to preventative medicine (e.g asthma)

4) Control
• Beliefs about treatment necessity correlate with beliefs how illness will be controlled
• E.g by treatment vs some other behavioural change

Question 7

What might concern of treatment also comprise?

What else may there be concerns about?

Answer 7

• Concerns about treatment may also comprise beliefs about illness representation
• E.g symptoms (identity) may stimulate concerns if they are interpreted as evidence that medication is not working e. taking antidepressants
• There may also be concerns about the necessity of treatment
• This may be interpreted as a threat to self-identity

Question 8

How are treatment beliefs and adherence linked?

Answer 8

• Treatment beliefs are strong predictors of reported treatment adherence
• E.g patients have treatment beliefs about chronic illnesses such as asthma and diabetes which will influence their adherence to taking their medication in order to stay healthy

Question 9

What is illness representation?

Answer 9

• Illness representation is the patients’ beliefs and expectations about an illness or somatic symptom

Question 10

How can treatment beliefs be integrated into the CSM?

Answer 10