compliance, adherence and concordance Flashcards
what is definition of adherence
the extent to which a persons behaviour corresponds with agreed recommendations of health care provider
what is compliance
a term no longer used because its a very negative definition but the extent to which a patient complies with medical advice
reasons for non adherence to medication
failure to pick it up,, stop before course complete, takes less/more than told to and missing it/ taking it at the wrong time
what situations does adherence fall
less serious conditions/ common conditions, or over. long period of time
consequences of non adherence
health benefits are lost, wider economic burden- wasted drugs and process of obtaining perscriptions etc
why is it difficult to measure adherence
difficult to say what actually is adherence (the cutoff point). At what point does a patient become non adherent to their medication
direct measurement of adherence
blood-test- however expense evasive and affect by metabolism, but does give good idea of adherence
indirect measurements of adherence
pill counts- however may be inaccurate
mechanical and electronic- doesn’t actually measure if medication has been taken
patient self report- affected by patient bias
second hand report done by a doctor- often inaccurate as well
what is unintentional non-adherence
forgotten them
can’t afford them
left them at home when on holiday
e t c
ALL practical problems
what is intentional non-adherence
deliberate non compliance with medication, due to beliefs attitudes and expectations.
may not have bad symptoms
want quality of life and no side effects
don’t want stigma of taking medication
may conflict with daily activities and lifestyle eg socially drinking
may modify treatment themselves eg reducing amount taken and reducing frequency
interventions to improve non intentional
educating the patient
simplifying the regimen
making medication easier to use
interventions to improve intentional
increasing patient involvement- increasing mindfulness (asking what the patient actually want and keeping them in the loop) increasing compliance
offering social support
improve quality of interaction
factors affecting adherence summary
Patient Factors Psychosocial Factors Healthcare Factors Treatment Factors Illness Factors
what is concordance
involves negotiation between patient and doctor, in which patients beliefs and priorities are respected, the patient is active and can make decisions in partnership with doctor.
how do we increase patient involvement
considering pros and cons
asking patient wha is actually important to them
dealing with misconceptions
barriers to non adherence
overcoming these improve patient trust and satisfaction
