Adherence And Compliance Flashcards
Define adherence.
Extent to which patient’s behaviour coincides with medical advice and shows active involvement.
Define compliance
Extent to which patient follows healthcare advice.
Define concordance.
Negotiation between patient and doctor over treatment regimes
Partnership
Patients beliefs and priorities respected and decisions shared.
Give three methods of measuring adherence and and identify their strengths and limitations.
Urine/blood test:
- adv. direct measure of consumption
- dis. Metabolism masks, invasive, clinical practice only
Observation:
- ensures consumption
- dis. Not long term
Pill counts:
- objective
- inaccuracy e.g. Lost pills
Patient self report:
- easy, inexpensive
- inaccuracies, bias, over reporting of adherence
What are the disease factors that influence adherence?
Presence and nature of symptoms
Severity of disease and state of health
What are the treatment factors that influence adherence?
Preparation- convenience
Character- complexity, duration, degree of behaviour change
Administration- carers
Consequences
What patient factors influence adherence?
Understanding
Recall
Beliefs- illness and medication
What psychosocial factors may impact on adherence?
Psychological: mental health, cognitive deficits
Social support: isolation vs family cohesion
Social context: stability, homeless
What healthcare factors influence adherence?
Organisational setting- venue, follow ups
The prescriber- beliefs and attitudes, title
Doctor patient interaction- perceived manner, communication and competence
Define intentional adherence.
Arises from beliefs, attitudes and expectations that influence motivation to begin and continue treatment.
Define unintentional adherence and give reasons.
Arises from capacity and resource limitations that prevent following of treatment.
Individual constraints e.g. Memory
Environment e.g. Accessing prescriptions
