Common Sense Model Of Treatment

Question 1

Self regulation

Answer 1

Problem solving
Homeostasis
Self-regulation model/concept

Question 2

Self regulation model/concept

Answer 2

• good health is ‘normal’
• illness is a problem
• we are motivated to solve problems

Interpretation
Coping
Appraisal

Question 3

Representation of illness

Answer 3

Identity
Cause
Timeline
Consequences
Cure/control

Question 4

Why are illness beliefs useful ?

Answer 4

Provide patients with a framework for coping with and understanding their illness:

– understand how different people make sense of different illnesses

– predict health behaviours

– change health behaviours

Question 5

What does treatment of chronic disease require ?

Answer 5

Adherence which is vital for optimal treatment outcomes.

Question 6

What do good treatment outcomes depend on ?

Answer 6

Good medical care
Self-management

Question 7

Adherence

Answer 7

Integrating disease as optimally as possible.

Question 8

Examples of some chronic diseases

Answer 8

Asthma
Diabetes
Kidney disease
Coronary heart disease
Cancer
HIV
Haemophilia

Question 9

Symptoms and Causes of Asthma

Answer 9

Recurrent attacks of breathlessness, wheezing.

Swelling of living of bronchial tubes –> narrow the airways and reduces flow of air in/out of lungs

Question 10

Statistics relating to asthma

Answer 10

• Leading preventable cause of morbidity, mortality & cost
• Affects 235 million people worldwide (WHO, 2016)
• Controlled not cured

Question 11

Treatment of asthma

Answer 11

Most children/ young adults with asthma are treated with inhaled steroids.

• 1st step in preventative therapy
• Largely safe and effective
• But, nonadherence is high…

Question 12

What is a self-management treatment in asthma ?

Answer 12

Steroid inhaler

Question 13

Results of non-adherence in asthma

Answer 13

Poor asthma control
Decreased quality of life
Lost productivity
Increased healthcare utilisation
Risk of death

Question 14

General results of non-adherence

Answer 14

Costly to provider and receiver
Wasted resources
Lack therapeutic benefit

Question 15

Give some examples of factors resulting in non-adherence

Answer 15

Side effects of medications
Poor provider-patietn relationship
Missed appointments
Complexity of treatment
Presence of cognitive impairment

Question 16

Factors affecting appropriate use of medication

Answer 16

Ability
Motivation
Beliefs

Question 17

Treatment ability

Answer 17

Misunderstanding
Forgetting
Daily schedule difficulties
Physical impairment

Question 18

Treatment motivation

Answer 18

Motivation to engage in & Maintain health-related behaviours

Question 19

Treatment beliefs

Answer 19

Certain beliefs about medicines are common across locations, cultures, treatment categories (Horne, 1997)

e.g. beliefs that medicines are: - addictive

• produce long term effects …

Question 20

2 categories of treatment beliefs

Answer 20

Necessity
Concerns

Question 21

Necessity

Answer 21

Personal need for treatment

Question 22

Concerns

Answer 22

Concerns about negative effects of treatment.

Can be concrete, abstract, relevant across range of disease states, cultures.

Question 23

What factor determines adherence ?

Answer 23

Perceived necessity determines adherence…more than treatment efficacy

Question 24

Assessment of treatment beliefs

Answer 24

Necessity-Concerns framework (BMQ - Beliefs about Medications Questionnaire)

• Specific necessity scale
• General harm & general overuse scale

Question 25

BMQ

Answer 25

Beliefs about Medications Questionnaire - valid and reliable

Question 26

Treatment beliefs Cost-benefit analyses

Answer 26

Personal evaluative summations necessity beliefs vs concerns COST-BENEFIT analyses determines ADHERENCE

Question 27

Function of the CSM of treatment

Answer 27

Use of CSM helps us understand the process by which treatment beliefs influence adherence

Question 28

Identity

Answer 28

Symptom experiences and expectations influence treatment necessity : – severity of symptoms – absence of symptoms (e.g. Hypertension)

Question 29

Cause

Answer 29

Putative causes of illness may influence need for treatment options: – changing diet vs taking medication...

Question 30

Timeline and Consequences

Answer 30

Perceptions of illness duration and consequences may influence treatment necessity: – perception of illness as cyclical vs chronic impacts on adherence to preventative medication (e.g. asthma)

Question 31

Control

Answer 31

Beliefs about treatment necessity beliefs correlate with beliefs how the illness will be controlled: – by treatment vs some other behavioural change....

Question 32

Concerns

Answer 32

CONCERNS about treatment also comprise beliefs about illness representations.

Question 33

Medication beliefs in asthma study

Answer 33

46% pts had doubts about need for preventative inhaler 43% reported concerns about adverse effects 1/3 pts thought doctors overprescribed medicines 17% pts thought medicines in general were harmful

Question 34

MARS

Answer 34

Medication Adherence Report Scale