4b Adherence to treatment

Question 1

Define adherence

Answer 1

the degree to which patient follows advice agreed by healthcare professional (doctor) + patient

Question 2

State some consequences of non-adherence.

Answer 2

• Increased hospital admissions (1 in 5 are because of non-adherence)
• Rejection of transplants
• Occurrence of complications
• Development of drug resistance
• Increased mortality

Question 3

What are the three main reasons for non-adherence?

Answer 3

Regime related factors = physical aspects e.g. packaging, complexity of administration, side effects, duration, cost etc
Doctor related factors = poor doctor-patient interaction  
Psychosocial variables (patient related factors) = does the patient know how to, can they do it, cultural/religious beliefs, volition etc

Question 4

List some ways of improving adherence to treatment.

Answer 4

Ask the patient
Simplify the regime (e.g. give a pill that’s taken once a day instead of one that should be taken every 3 hours/ 4 times a day if there is such choice) and packaging
Improve the doctor-patient interaction (communication style and presentation)
Identify and modify beliefs
Involve significant others, wider network and potential to use assistive technology
Make regimen plan
Make sure patient understands the treatment plan
Accommodate their needs e.g. child given syrup instead of pill

Question 5

What are the 2 aspects/ determinants of a patient’s specific beliefs of prescribed medication?

Answer 5

• Necessity: beliefs about necessity of prescribed medication for maintaining health
• Concerns: arising from beliefs about potential negative effects