(7) Adherence

Question 1

What is compliance?

Answer 1

Extent to which the patient complies with medical advice

Patient does what they are told, doctor knows best

Question 2

What is adherence?

Answer 2

The extent to which a person’s behaviour corresponds with agreed recommendations from a healthcare provider

(More patient-centred, patient’s right to choose)

Question 3

What is concordance?

Answer 3

Agreement reached after negotiation between a patient and healthcare professional, that respects the beliefs and wishes of a patient

Question 4

What are the problems of non-adherence to medical advice?

Answer 4

Health benefits forgone (poor health-related quality of life, increased hospitalisation)

Wider economic burden (personal, health, social cost)

Question 5

What factors influence patient non-adherence?

Answer 5

Unintentional non-adherence = practical problems

Intentional non-adherence = patient doesn’t want to

Question 6

How can adherence be improved?

Answer 6

Educating patient on the medicine to increase their knowledge

Simplifying the regimen

Making it easier to remember to use the medicine (physical aids and reminders)

Question 7

What factors influence adherence?

Answer 7

Patient factors = believes, understanding, memory, satisfaction

Psychological factors = social support, psychological health

Healthcare factors = setting, doctor-patient interaction, communication, concordance

Treatment factors = preparation, side-effects, complexity, experience, efficacy, stigma

Illness factors = symptoms, severity