5: Treatment Adherence Flashcards
What is compliance?
What is treatment compliance?
the action or fact of applying with a wish or command
–> extent to which patients follow doctors’ prescription about medicine taking
–> old fashioned term because it is too one sieded –> patiene follows doctors order
What is adherence?
What is the difference to compliance?
refers to the extent to which patients follow through decisions about medicine taking
What are the differnt forms of adherence?
It is a wide spectrum from
- Overadherence via
- perfect adherence to
- uneradherenace
How many pople usually adhere to their recommended treatment?
In long-term conditions: about 50% adhere to treatment
What are the consequences of non-adherence to treatment?
•Poor health outcomes
•Increased healthcare costs
- Viswanathan et al. (2012) – It is estimated that in the USA, a lack of medication adherence:
- Causes nearly 125 000 deaths per year
- Causes 10% of all hospital admissions
- Costs the healthcare system $100-289 billion per year
What is the differnece between and the relation of intentional and unintentional non-adherence?
Unintentional
- a patient does not have the capability or resources to adhere to the treatment
Intentional :
- patiens beliefs and motivations lead to non-adherence (e.g. avoid side-effects etc)
Relation:
- they overlap e.g. if someone does not consider medication important (belief) it might be more prone to forgetting it
Explain the COM-B model
It is a model to describe behaviour
- Capabilita, Opportunity and Motivation all (bidirectionally) influence behaviour
- Capability and Opportunity also directly influence Motivation
Explain the role of capabiliy in the COM-B model in regards to adherence
- Psychological –> Capacity to engage in the thought process
- unterstnadment of disesase and treatment
- cognitive funciton (unterstanding, juding)
- Executinve funciton (planning)
- Physical
- ability to adapt to lifestyle changes (e..g walk to supermarket etc.)
Explain the role of Opportunity in regards to treatment adherence (COM-B model)
- Physicla opportunity
- financial resources
- access (availibilty of medicaiont)
- characteristic of medicine (taste, smell, ROA)
- Social support
- Social
- religious beliefs
- stigma of disease/fear of disclosure
Explain the role of Motivation in treatement adherence in regards to the COM-B model
- Reflective (Evaluation and plans)
- perception of illness
- beliefs about treatment
- outcome-expectancy
- self-efficacy
- Automatic (emotions)
- mood state/disorders
- stimuli or cues for action
Which factors highly influence treatment adherence in regards to perception of the treatment?
- Doubt about Necessity of treatment with
- Concerns about side-effects
–> low adherence
What are interventions that can be made to increase treatment adherence?
- Improve understanding of illness and treatment
- Help patients to plan and organise their treatment –> e.g. via daily text message, incoorperating wife to put tablet onto table etc.
–> Can already be via simple methods
What can be done in a consultation to facilitate informed adherence
Check the patient’s understanding of treatment, and if necessary:
- Provide a clear rationale for the necessity of treatment
- Elicit and address concerns
- Agree a practical plan for how, where and when to take treatment
- Identify any possible barriers
