Adherence and Concordance Flashcards
name the side effects the oxybutylin can lead to
Anti muscarinic medicine
- dry mouth
- constipation
- blurred vision
- cognitive impairment - older adults more susceptible
Define adherence
- To the extent to which the patients behaviour matches agreed recommendations from the prescriber
define compliance
- The extent to whcih the patients behaviour matches the prescribers recommendations
Why is the definition of compliance criticised
- relegates the role of the patient to one of passive recipient of medical advice
define concordance
- A process of prescribing and medicine taking based on partnership
- idea that medicines should be shared by prescriber and patient so that they can arrive at a harmonious agreement regarding therapeutic decisions that incorporate their respective views
What three things are included in concordance
- knowledge
- partnership
- support
concordance does not..
specifically address medicines taking behaviour
concordance can have an impact on ..
meidcines taking behaviour
What can effect adherence to medicine taking behaviour
- Shared decision making
What is the adherence to long term therapies
- may be as low as 50%
In the UK less than 50% of
patients eligible for treatment receive optimal therapy for their condition
- low levels of adherence to prescribed medication is believed to be a major contributory factor
How many medications are not taken as recommended
- between a third and half of all medicines
What conditions do people not take medicines the most
- astham
- hypertension
- diabetes
- HIV/AIDs
- dyslipidaemia
- epilepsy
what patient group is least likely to believe medicines were necessary
- Patients with asthma were the least likely to believe that their medicines were necessary and the most likely to say that their costs outweighed their benefits
- also the least compliant
in 2018-19 how much did NHS spend of medicines
- 9 billion
- cost of unused or unwanted medicines vary from 100 million to 300 million
why is the economic cost not limited to take medicines
- non adherence has the potential to limit the benefit of prescribed medicines
- a lack of improvement or deterioration in health has a direct impact on the NHS
- leads to increased demand on GP surgeries and hospitals at an additional cost
Patients who adherence to treatment..
have better health outcomes that patients who do not adhere to treatment
Why do people not adhere
- social economic factors - age, gender, an inability to pay for medicines
- health system/health care team factors - poor quality of instructions provided to the patient
- therapy related factors - adverse effects of medicines, complexity of drug regimens
- patient related factors - patient disagreement with the necessity for treatment, low elf esteem
- condition related factors - dysphagia in myasthenia gravis
what age group are less adherent to medication
- Adolescents are less adherent to prescribed medication regimens than younger people
who tends to be more adherent than all other age groups
- 30-65 year olds
what group of people have poor adherence
- older populations where the patients have multiple chronic diseases is a particular problem
- the prevalence of function and cognitive impairments in older patients increases their risk of poor adherence
How do you improve adherence in children under 12
- they should be given the choice of swallowing tablets, or a liquid form or solid dosage form
describe how socioeconomic deprivation can effect adherence to medication
- people who have high socioeconomic deprivation are more likely to have a low level of eduction, be unemployed, have limited social networks, experience poor housing conditions, suffer from family dysfunction
- these can influence their beliefs about health, illness and treatment