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DEN2025 - Dental Public Health and Behavioural Science > Adherence in Dentistry > Flashcards

Adherence in Dentistry Flashcards

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1
Q

What is adherence?

A

Patient’s ability and willingness to follow recommended health practices including maintaining these

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2
Q

How high is nonadherence for medicines?

A

30-50%

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3
Q

Name 2 umbrella terms of nonadherence?

A
  1. Unintentional nonadherence

2. Intelligent nonadherence

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4
Q

Name 3 types of nonadherence

A
  1. Fulfilment
  2. Non-Persistence
  3. Non-Conforming
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5
Q

What is fulfilment in terms of nonadherence?

A

Prescription is never filled or initiated by the patient

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6
Q

What is non-persistence in terms of nonadherence?

A

A patient decided to stop taking medication on their own, usually due to miscommunication of the therapeutic plan

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7
Q

What is non-conforming in terms of nonadherence?

A

Medication is not taken as prescribed e.g. skipping doses, taking incorrect doses

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8
Q

Name 5 categories of risk factors related to nonadherence

A
  1. Social and Economic
  2. Health Care System
  3. Condition Related
  4. Therapy Related
  5. Patient Related
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9
Q

Describe 4 components of social and economic risk factors related to nonadherence

A
  1. Limited language proficiency
  2. Low health literacy
  3. Homelessness
  4. Medication cost / Lack of insurance
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10
Q

Describe 4 components of health care system risk factors related to nonadherence

A
  1. Patient-provider relationship
  2. Long wait times
  3. Lack of care continuity
  4. Restricted formularies
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11
Q

Describe 4 components of condition related risk factors related to nonadherence

A
  1. Lack of symptoms
  2. Severity of symptoms
  3. Depression
  4. Psychotic disorders
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12
Q

Describe 4 components of therapy related risk factors related to nonadherence

A
  1. Complexity of regimen
  2. Duration of therapy
  3. Frequent changes
  4. Actual or perceived side effects
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13
Q

Describe 4 components of patient related risk factors related to nonadherence

A
  1. Visual, hearing or cognitive impairment
  2. Knowledge about disease
  3. Perceived susceptibility to disease
  4. Motivation and confidence
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14
Q

Describe Ley’s Model of Compliance

A
  • Understanding and memory lead to satisfaction
  • Understanding, memory and satisfaction all lead to compliance
  • Compliance shifts to adherence which shifts to concordance
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15
Q

Describe how health literacy can be a barrier to adherence

A
  • Mismatch between patients’ health literacy skills and informational demands by provider
  • Many patients have difficulty understanding information
  • Patients forget up to 80% of what physicians tell them
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16
Q

Describe the effects of low health literacy

A
  • Lower knowledge, poor adherence, fewer preventative services and increased cost
  • Barrier to effective prevention and treatment
17
Q

Name 3 factors relating to the dentist which can influence nonadherence

A
  1. Communication skills
  2. Personal beliefs
  3. Personal knowledge of patient
18
Q

Name 4 problems associated with diabetes

A
  1. Hypoglycaemia
  2. Circulation problems
  3. Heart problems
  4. Vision problems
19
Q

Name 4 reasons why a person with diabetes may not adhere to doctor’s advice

A
  1. Embarrassment of testing and injecting in public
  2. Lack of family / social support
  3. Restriction on normal daily routine
  4. Feeling different by following an alternative diet
20
Q

Name 1 reason why there may be poor patient adherence in dentistry in terms of reward

A

Patients are asked to act to avoid disease in the future and immediate benefit can be hard to see

21
Q

Describe 4 ways which nonadherence in dentistry can have health and financial implications

A
  1. Missing appointments
  2. Failing to follow oral health advice
  3. Failing to change daily routine
  4. Not wearing appliances
22
Q

Name 5 parental views on factors influencing tooth brushing in children from Duijster D et al., study in 2015

A
  1. Parenting strategies
  2. Parental monitoring and supervision
  3. Parental knowledge
  4. Perceived importance
  5. Tooth brushing routines
23
Q

Name 5 parental views on factors influencing children’s consumption of sugary foods and drinks from Duijster D et al., study in 2015

A
  1. Affordability of food
  2. Commercials and television
  3. Social environment
  4. Dietary routines
  5. Parental control on diet at home
24
Q

How does adherence relate to treatment of periodontal disease?

A
  • Treatment is based around effective self care
  • Success dependent on information and motivation
  • Behaviour change required
25
Q

Suggest 2 reasons a person may not wear a retainer to improve long term success in orthodontic treatment

A
  1. Lack of immediate reward
  2. May not be involved in decision making (young child)
  3. Laziness
  4. Comfort levels
  5. Lack of knowledge of the benefits
26
Q

Suggest 4 ways to improve information giving in dentistry

A
  1. Use of written information a patient can take away
  2. Proper in surgery e.g. x-rays / models
  3. Frequent summaries and get patient feedback
  4. Give most important information first and last
27
Q

What is the main 2 methods of person-centred strategies for improving adherence?

A
  1. Teach back

2. Ask 3

28
Q

What does DIIF stand for in terms of improving adherence?

A
  • Discuss (difficulties and benefits)
  • Improve (improve communication)
  • Include (written information where possible)
  • Follow (follow up)

DEN2025 - Dental Public Health and Behavioural Science (25 decks)

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