ADHERANCE

Question 1

Compliance definition?

Answer 1

Refers to the extend of conformity to the recommended treatment to the dose, frequency and timing

Question 2

Adherence definition?

Answer 2

Refers to the extent to which the pt behaviours match the agreed recommend treatment provided by the prescriber

Question 3

Adherence to treatment examples ? 4

Answer 3

-taking the medication
-attending follow up appointments
-change lifestyle
-monitor test result

Question 4

Primary non adherence?

Answer 4

Pt not fulfilling the Rx

Question 5

Secondary non adherence? 3 examples

Answer 5

-overuse
-missing dose
-change dose, time and frequency

Question 6

Not persistence definition?

Answer 6

Refers to the inability of the pt to follow the recommended length of the treatment.

Question 7

Effects of non adherence? 4

Answer 7

-increased mortality
-increased morbidity
-decreased quality of life
-increase NHS costs

Question 8

3 myths of non adherence?

Answer 8

-feature of the disease
-linked to socioeconomic determinants
-easily resolved by: providing info, providing reminders, being authoritative

Question 9

When is adherence achieved?

Answer 9

When pt treatment fits with:
-pt routine
-pt preference
-pt expectations

Question 10

Unintentional non adherence?

Answer 10

Passive behaviour in which the pt fails to follow dr recommendation

Question 11

Intentional non-adherence ?

Answer 11

The active choice of the pt not to follow dr recommend treatment

Question 12

How can you assess non adherence? 5

Answer 12

-direct observation
-counting pills
-smart blister
-access Pharmacy records
-monitor outcomes

Question 13

COMB MODEL explained ?

Answer 13

It is a framework which identifies 3 areas involved in non adherence:
-capability
-motivation
-opportunity

Question 14

CAPABILITY definition ?

Answer 14

It Includes all the psychological and physical capacity of the pt to perform a specific task

Question 15

Motivation definition?

Answer 15

All brain processes that make a behaviour possible:
-automatic (mood habits)
-reflective (perception of the illness, expectation of the treatment, beliefs around treatment)

Question 16

Opportunity definition?

Answer 16

Refers to all factors lying outside the individual or make a behaviour possible
-social (pt/dr relationship, stigma of disease)
-physical (cost of medication)

Question 17

Necessity concern framework explained?

Answer 17

This framework explains there are two factors influencing non adherence:
-necessity (belief about the necessity of the treatment)
-concerns (related to the potential side effect)

Question 18

Adherence intervention includes? 2

Answer 18

-implement intention
-target mistaken beliefs, to change behaviour

Question 19

How to maximise adherence? Reference to framework

Answer 19

-address the necessity of the treatment to the pt
-elicit and address concerns related to the medication possible side effects
-make a plan with the pt
-identify barriers to the plan

Question 20

Illness perception 5 stages?

Answer 20

-identity
-cause
-consequences (for it and families)
-cute
-timing