8.1 Adherence Flashcards
What is adherence?
The extent to which patient behaviour coincides with medical advice
What conditions have a high adherence rate?
HIV, arthritis, GI disorders, cancer
What conditions have a low adherence rate?
Diabetes, sleep disorders, pulmonary disease
What are the negative implications of non-compliance?
Wasted appointment time
Wasted money on drugs
Poorer patient health
Readmissions due to non-compliance
What is a ‘pill-count’?
A pill is dispensed at a certain time every day by electronic equipment. The number of pills left after a certain amount of time will show adherence.
Why may a patient not adhere to treatment (with regard to their illness)?
They may have no symptoms so not feel the need to take the medication
The disease may not be life-threatening
The patient may give up with treatment if the condition is severe
Why may a patient not adhere to treatment (with regard to their treatment)?
The drug may be inconvenient to take
The drug may have negative side effects
The patient may not be observed taking the treatment so get away with non-compliance
They may not understand what the drug is doing to them
Why may a patient not adhere to treatment (with regard to the patient)?
The patient may not believe in taking medications
The patient may reject the medication based on beliefs
Why may a patient not adhere to treatment (with regard to their psychosocial background)?
May have psychological issues
May have a lack of cognitive ability
May have a lack of family support
May be very socially isolated
Why may a patient not adhere to treatment (with regard to their Healthcare)?
May have a negative healthcare experience
May have to wait a long time for a diagnosis or medication
The prescriber must also believe that the medication is the right option
When does unintentional non-compliance occur?
Arises from capacity and resource limitations
When does intentional non-compliance occur?
Arises from beliefs, attitudes, expectations and the patient’s motivation to persist with treatment
What can be done to increase adherence?
Look at motivation Reduce practical barriers Try to find reason behind non-compliance Try to be more patient-centred Look at effectiveness of treatment in that specific patient
What is concordance?
The nature of the interaction between the clinician and the patient. The patient should be active and it should be a discussion rather than the patient being told what to do
Give examples of good concordance when prescribing medication?
Define the problem Discuss treatment options Provide information to take away Check patient understanding of how to take medication and what it does ICE
