Bulpitt - Adherence To Medical Regimes Flashcards

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1
Q

Aim

A

To investigate adherence in hypertensive patients

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2
Q

Method

A

Review article of research into problems with taking drugs for high blood pressure.

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3
Q

Findings

A

1: Anti-hypertension medication can have many side effects
Eg. Dizziness, CAUSE SEXUAL PROBLEMS.
This unacceptable level of side effect is a major factor causing patients to withdraw from treatment.

2: Curb - 8% males discontinued treatment because of sexual problems.
3: Medical research council trail for 5 years found 15% withdrawn taking medicating due to gout, impotency and lethargy.
4: 9% discontinued for definite side effects, further 23% for possible side effects
5: Effect cognitive functioning, therefore work and hobbies curtailed as ability to function effectively decreased. Effects depend on drug. More prevalent in elderly as blood pressure drops when standing or moving about.
6: Being tired may effect hobby or relaxation activities.. Making movements and concentration more difficult. 27% from study in Germany said hypertension interfered with hobbies eg, walking, gardening and reading

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4
Q

Conclusion

A

When costs of taking medication outweigh the benefits there is less likelihood of patient adhering to the treatment.
Rational choice not to take due to sexual side effects.

SUPPORTS HBM AND COGNITIVE APPROACH.

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5
Q

Non adherence

A

Do not take medication or follow medical advice.

Irrational behaviour as cannot see or feel the change.

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6
Q

Rational non-adherence

A

Positive decision not to take the medication
Rather than just forgetting.
MAKE A CHOICE (maybe based on HBM - costs outweigh the benefits).

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7
Q

Hypertension

A

Asymptomatic… No obvious symptoms eg. High blood pressure

Therefore increase likelihood for rational non-adherence.

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8
Q

Procedure

A

Wellbeing of participants with high blood pressure… Looks at:
Affect on quality of life and it’s complications.
Other associated illnesses eg. Depression.
Treatment prescribed.

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9
Q

Sexual problems

A

Side effect of anti-hypertension drug, erectile problems leading to impotence. Significant cost to men and do not want to take.

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10
Q

Symptoms got worse

A

Sleepiness, diarrhoea and male sexual dysfunction.

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11
Q

Symptoms got better

A

Headaches, unsteadiness and depression

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12
Q

Reliability

A

Cross referencing of studies increases reliability and generalisability.
Based on a range of research and provides cumulative evidence.

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13
Q

Useful

A
  • researchers can look at patterns over time of research for different studies, and how attitudes to medication and adherence change over time.
  • help doctors understand how best to promote medicalisation if we understand why people are less likely to adhere.
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14
Q

Validity

A

Data collected should be much more controlled and questionnaires properly validated.

Eg. Increase control by double blind to treatment patient is getting.

Review study = not clear how studies were selected and whether they were representative of all research or whether they were chosen to fit Bulpits views.

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15
Q

Holistic

A

Quality of life approach takes into consideration the side effects of therapy (sexual dysfunction), psychology well being (other associated illness - depression/anxiety), and work/leisure performance.

This is because it looks at physical and psychological side effects.

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16
Q

Reductionist

A

Focuses on cognitive factors and ignores other important factors.
Eg.
1: irrational behaviour eg. Weinsteins research on optimism
2: ignores role of doctors eg. Kent and Waitkin

28
Q

Kent

A

Understanding and memory.

Patients forget up to 50% of instructions within minutes of leaving the surgery.

29
Q

Watkin

A

Observational study.
Proportion of time doctors spent informing patients about treatment or illness.
AV time with patients 20mins, of which one spent informing them.