Adherence and Concordance Flashcards
Define adherence
The extent to which the patient’s actions match agreed recommendations
What is compliance?
Assumes doctor knows best.
Assumes passive patient- the patient should follow doctor’s orders
What is adherence
Acknowledges the importance of patient’s beliefs, but health professionals are still experts in conveying their knowledge.
- Communication to enhance patient knowledge, satisfaction and adherence to the recommended medical regime
- More patient-centred approach is needed to support adherence
What are necessary beliefs
perceptions of personal need for treatment
-concerns about a range of potential adverse consequences
What is patient-centeredness
- Shift in focus from treatment to the process of care
- A philosophy of care that encourages:
o Focus in the consultation on the patient was a whole person who has individual preferences situated in a social context
o Shared control of the consultation, decisions about interventions or management of health problems with the patient
What are the impacts of Good Dr - patient communications
- Better health outcomes
- Higher adherence to therapeutic regimens in patients
- Higher patient and clinician satisfaction
- Decrease in malpractice risk
What are the key principles of good Dr-patient communication
- Improve communication
- Increase patient involvement
- Understand the patient’s perspective
- Provide information
- Assess adherence
- Review medicines
Describe how you would improve communication (Dr-patient communication)
a. Adapt consultation style to the patient’s needs
b. Encourage patients to ask questions
Describe how you would increase patient involvement (Dr-patient communication)
a. Explain the condition, pros and cons of treatment
b. Clarify what the patient hopes the treatment will achieve
c. Record the decision if the patient decides not to take a medicine, and this could be harmful
Describe how you would understand the patient’s perspective (Dr-patient communication)
a. Ask patients what they know, believe and understand about their medicines and treatment
b. Ask about any concerns they have
Describe how you would provide information (Dr-patient communication)
a. Offer patients clear, relevant information on their condition and possible treatments – discuss rather than present info
b. Offer individualized information that is easy to understand and free from jargon
Describe how you would access adherence (Dr-patient communication)
a. Routinely assess adherence in a non-judgmental way whenever you prescribe, dispense and review medicines
b. Consider using records to identify potential non-adherence
Describe how you would review medicines (Dr-patient communication)
a. Review patient’s knowledge, understanding and concerns about medicines
b. Ask about adherence when reviewing medicines
Describe concordance
- Extension of principles of patient-centered medicine
- Rather than thinking about health care relationships as a means of enforcing the doctor’s instructions, we now think about patients more as equals in care
- It is expected that patients will take part in treatment decisions and have a say in the consultation
- Most work addresses prescribing/medication – the term adherence is still used
Barriers to concordance regarding patients
- Do patients want to engage in discussion with their doctor
- Research indicated that in some cases, it might serve to worry the patient more
- Patients may simply want the doctor to tell them what to do, where medical decisions are complex or based on complicated statistical risks
