Ch. 4 Adherence to Healthy Behavior

Question 1

What is Adherence?

Answer 1

degree a patient carries out recommended behaviors & treatemens

(rest, take medicines at x time trhough x days, etc)

Question 2

Adherence can be Measured by..

(ways that doctors can know wheter or not if the patient is following re

Answer 2

• Patient reports
• Family or friends reports
• Monitoring Med use (a.k.a. pharmacy records)
• Biochemical evidence

Question 3

Rates of non-adherance in Real Life

Answer 3

• 25% non-adherence to medicine
• 1/3 of prescriptions written in US are not filled
  e.g., 1/2 continued as needed for health benefits

Question 4

Consequences of Non-adhereance

Answer 4

Delayed recovery and illness worsens

Question 5

What are some consequences of non-adhereance?

Answer 5

• Increase treatment failure
• Increase morbidity (co-occurrence of disease)
• Increase Healthcare -> more money spend
• Higher U.S. mortality!

Question 6

Morbidity

Answer 6

the condition of suffering from a disease or medical condition

Question 7

Predictors of Adherence

Answer 7

Disease factors,
Treatment factors,
and
Patient factors

Question 8

Disease factors

(predictors of adherence)

Answer 8

• Acute rather than chronic
• Participants perception of severity
  Not objective severity

Question 9

Treatment Factors

(predictors of adherence)

Answer 9

• Medicine better than behavior (e.g., pill vs exercise)
• Simple over complex regiments (e.g., + side-effects lower adherence)
• Duration of treatment

It’s not just IF a patient is non-adherent, but WHY

Question 10

Patient Factors

Answer 10

• Not many Age, Gender, Personality difference
  context-specific differences
• Increase in depression & anxiety leads to an increase in adherence
• Higher SES leads to increase in adherence
  ethnics differences disappear after coontrolling for SES!

Question 11

What are the two factos as to why Dr. to Patient communication fails?

Answer 11

Physician Behaviors and Patient Behaviors

Question 12

Physician Behaviors

(Failures in Dr. - to Patient communication)

Answer 12

• Not listening/explaining well (e.g., using jargon)
• Lack of empathy/Positive reinforcement
• Implicit/explicit bias!

Question 13

Patient Behaviors

(Failures in Dr. - to Patient communication)

Answer 13

• Don’t ask Qs or tell whole story
• Increse Anxiety of visit
• Increase PERD (Perception of Ethnic and Racial Discrimination) leads to lower diclosure and adhereance.

Question 14

Research Suggests a ‘model’ doctor is who…

Answer 14

A doctor who is
* respectfull
* confident
* through
* personal
* empathetic
* humane
* forthright