Adherence to treatment Flashcards
What has the doctor centred approached shifted to?
Shifted to a patient-centred approach and consultation style
What is meant by the patient-centred approach?
Not just considering the disease, but the patient as a whole
-holistic approach- treatment of the whole person
What is compliance?
Compliance is a passive behaviour in which a patient is following a list of instructions from a doctor
What is adherence?
Adherence is a more positive, proactive behaviour which results in a lifestyle change by the patient, who must follow a daily regimen
Why is it hard to check if someone is adhering to medical advice?
- As the patient may estimate or lie
- Can’t count quantity as the patient can dispose of them
- Biomedical tests are intrusive and expensive
Why is non-adherence a problem?
People who do not adhere may be putting their health at further risk
-cost -of the medication, repeated appointment, further treatment (long and short term cost effects)
What type of illnesses has a higher level of non-adherence?
Chronic illnesses have less chance of adherence as they often involve daily regimes or lifestyle changes
What factors can influence whether a patient follows medical advice?
Social factors- low levels of education/ support
Psychological factors- High anxiety and depression, non-acceptance of illness, avoidance and denial, stigma
Treatment factors- complexity of regimen, side effects, poor communication between doctor and patient
What is Ley’s model?
Ley’s model of patient adherence in 1989 outlines how patient adherence is influenced by 3 factors, patient understanding, memory and satisfaction
-and that increasing these factors can increase adherence
What are the 3 factors outlined by Ley’s model that influence patient adherence?
Understanding- understanding what to do
Memory- remembering what to do
Satisfaction- happy with it? emotions
How can a medical practitioner increase patient understanding?
Using simple, ‘plain language’
Be structured
Encourage the patient to ask questions and check their understanding
How can a medical practitioner increase patient memory?
- The memory of verbal info may be poor, so creating a handout or visual aid to take home
- High anxiety interferes with recall so making the patient feel relaxed
- Give important info first- primacy effect- early info remembered better
How can a medical practitioner increase patient satisfaction?
Satisfaction depends on the level of emotional support from the practitioner, perceived adequacy of explanations and perceived competence of the practitioner
What are 2 examples of practitioners increasing medical adherence?
Tang and Newcomb- created a personalised print out to increase satisfaction, understanding and memory
Tattersall- gave audiotapes or letters to increase satisfaction, understanding and memory
What is concordance between practitioner and patient?
Concordance is a doctor and patient working together to get the best outcome
-the ultimate aim to improve adherence
