Adherence to Treatment

Question 1

Define Adherence

Answer 1

Attachment or commitment to a person, cause, or belief

Question 2

Describe the COM-B model

Answer 2

COM-B model of behaviour – the performance of a behaviour is caused by the interaction between capability, opportunity and motivation

Question 3

What does capability refer to in the COM-B model

Answer 3

the individuals physical and psychological capacity to engage in this behaviour

Question 4

What does motivation refer to in the COM-B model

Answer 4

all brain processes that energise and direct behaviour

Reflective and automatic

Question 5

What does opportunity refer to in the COM-B model

Answer 5

all factors (physical and social) lying outside the individual that make performance of the behaviour possible and prompt it

Question 6

Give examples of factors that contribute psychological capability of adherence

Answer 6

Comprehension of the disease and treatment
Cognitive function
Executive to function (capacity to plan)

Question 7

Give examples of factors that contribute physical capability of adherence

Answer 7

Physical capability to adapt to lifestyle changes

Dexterity

Question 8

Give examples of factors that contribute reflective motivation of adherence

Answer 8

Perception of illness
Belief about treatment
Outcome expectations
Self-efficacy

Question 9

Give examples of factors that contribute automatic motivation of adherence

Answer 9

Stimuli or cues for action

Mood state/disorder

Question 10

Give examples of factors that contribute physical opportunity of adherence

Answer 10

Cost
Access
Packaging 
Physical characteristic of medicine 
Social support

Question 11

Give examples of factors that contribute social opportunity of adherence

Answer 11

Stigma of disease
Fear of disclosure
Religious/cultural belief

Question 12

Give examples of ways to improve adherence to treatment

Answer 12

Do no assume adherence - ask
Simplify regime and packaging
Improve interaction (communication style and presentation, esp. written)
Identify and modify beliefs
Using the consultation to facilitate informed adherence

Question 13

Give examples of how one may identify and modify beliefs to improve adherence

Answer 13

Involve significant others and wider network and potential to use assistive technology e.g. Reminder (tailored text messages)

Question 14

Give examples of how the consultation can be used to facilitate informed adherence

Answer 14

Check the patient’s understanding of treatment, and if necessary:

• Provide a clear rationale for the necessity of treatment
• Elicit concerns that they may have regarding treatment
• Agree a practical plan for how, where and when to take treatment