adherence Flashcards
adherence
extent to which a patient’s behaviour matches agreed recommendation from the prescriber
compliance
extent to which the patient’s behaviour matches the prescriber’s recommendations
What does non-adherence include?
1) failing to get first prescription/subsequent repeats dispensed
2) discontinuing medicine before course of therapy is completed
3) taking more/less medicine than prescribed
4) taking dose at wrong time
What long-term conditions have adherence issues?
1) asthma
2) cardiovascular disease
3) depression
4) diabetes
5) chronic obstructive pulmonary disease (COPD)
6) parkinson’s disease
What are the causes of non-adherence?
1) cost of medicines
2) adverse effects
3) interactions
4) timing of doses
5) use of devices
6) complexity of regimen
7) physical ability
What are the NHS consequences?
1) increased spend to counter sub-optimal patient management
2) increased clinical risk due to additional prescribing
3) cost of medicines dispensed but not used
4) cost of safe disposal of unwanted medicines
What clues show non-adherence?
1) unused medicine
2) items not ordered on repeat prescription
3) old dates on repeat prescription
4) old date on dispensed medicine labels
5) patient response to treatment
6) patient understanding of medicine
Why do some patients intentionally non-adhere?
1) cost
2) reducing/omitting doses to avoid side effects
3) concern about value/appropriateness of medicine
4) worry about addiction#
5) worry about stigma
6) non-acceptance of illness
What factors influence unintentional non-adherence?
1) confusion over dose + frequency
2) confusion over additional instructions
3) forgetfulness
4) physical difficulties
How can we help with adherence?
1) educate patient on medicine to increase their knowledge
2) simplify regimen
3) make it easier to remember to use the medicine
How can you increase patient involvement?
1) clearly explain the condition and pros + cons of treatment
2) clarify what patient hopes treatment will achieve
3) talk + listen to patient rather than making assumptions about patients’ preferences about treatment
4) help patients make decisions based on likely benefits + risks rather than misconceptions
5) accept patients may have different views from healthcare professionals
6) accept that patients have the right to decide not to take medicine
What are good consultation skills?
1) effective communication
2) don’t be judgemental
3) ask open-ended questions
4) listen to patient’s concerns
5) explore, empower, enable, educate
