Adherence to Medical Advice

Question 1

What is adherence?

Answer 1

the degree to which the person’s behaviour corresponds with the agreed recommendations from a healthcare provider.

Question 2

2 types of non-adherence

Answer 2

• Failure to follow treatments
• Failure to attend appointments

Question 3

Failure to follow treatments(3)

Answer 3

• Primary non-adherence- occurs when doctor writes a prescription, but the medication is never collected;(the patient does not hand in the prescription to get the medication they have been prescribed)
• Non-persistence- occurs when the patient starts to take the medication but stops, without being advised to do so by a medical professional. Unintentional and happens due to a miscommunication between the patient and the medical professional , or due to the patient’s difficulty in following treatment due to cost issues, diffculty accessing medication, forgetting to take the medication, etc. Intentional non-adherence is less likely, but tends to take place due to patients’ beliefs, attitudes and motivation
• Non-conforming- this involves ways in which medication is not taken as prescribed. This could include missing doses, taking medication at incorrect times or in incorrect doses.

Question 4

Problems caused by non adherence

Answer 4

• Waste of medication- if medication is received and not taken it’s wasted, which has huge economic consequences, as well as potential issues relating to supply and demand
• Time lost due to missed appointments- Research done by the Doctor Patient Partnership and Institute of Healthcare Management in the UK found that 17million GP appointments and 5.5million practice nurse appointments were missed in 2000, At an estimated cost of 150 millions pounds
• Progression of illness: if medication isn’t taken the illness will most likely progress leading to possible hospitalization, or stronger,more invasive treatments being required in the long term.
• Increased use of medical resources: related to the progression of illness, if untreated a condition can worsen to the point where the patient may require hospital visits, admissions and admission to nursing homes.
• Reduced functional abilities: if condition/disease is left untreated it can affect the patient’s ability to function properly and may leave them unable to work etc.
• Lower quality of life- when left untreated as well as the symptoms worsening, so will the quality of life of the patient, this will likely continue to decline until treatment is adhered to.
• Impact on medical research- researchers who’re trying to establish the value of medications for target populations are less able to move forward with their research if courses of treatment are not completed fully.

Question 5

Explanations of why people do not adhere

Answer 5

1. Rational non-adherence
2. Health Belief Model

Question 6

Rational non-adherence

Answer 6

People do not adhere because of a deliberate decision to adjust medication.
Many reasons for this such as side effects, perception of the effectiveness of the medication and cost
CASE STUDY: Laba et al.: