Concordance Flashcards
Define concordance
A negotiated, shared agreement between HCP and patient concerning treatment, behaviour, outcome (more co-operative than compliance)
Define compliance
Patient fulfills HCPs recommendations for treatment
Define adherence
The extent to which a patients behaviour e..g taking medication corresponds with agreed recommendations from HCP
Factors affecting concordance
Patient centred demographic: concordance increases with age until elderly. Marriage increases concordance
Psychological: threat of illness? Belief that treatment works?
Patient/HCP relationship: trust? Previous experienc?
Health literacy
Healthcare system: availability/accessibility, waiting times, quality of consultation
Disease: fluctuating/absent symptoms, improvement of symptoms due to Rx
SE: time for appointments, cost of treatment, support network
Therapy related: duration of treatment, route of administration, side effects, freq of treatment
Why is concordance important?
Improves health outcomes and reduces long term complications of chronic illness + reduces financial burden to healthcare systems
Define adolescence
10-19 years (higher mortality and morbidity rates than childhood)
Define risk behaviours
Potentially expose people to harm or risk of harm that are associated with poor health/psychosocial outcomes
Risk taking and brain development?
Some risk taking is developmentally appropriate exploratory behaviour. Happens in adolescence due to disparity in maturation between lambic system and prefrontal cortex
Young people and self management
Long term self management is initiated during adolescence
Period of transition where young person takes over responsibility for their condition
Successful transition essential as determines management strategies for adult life
Concordance - an issue due to learning and trying to fit in
Why can self management in young people be difficult
Inconvenient + disruption. Social activities take priority
Feelings of being controlled by parents/ HCPs
Wanting to fit in
Diabetes management in young people
Control often deteriorates in adolescence
HbA1c increases with age, females tend to be higher at all ages
Adolescent girls and self management of diabetes
girls: more likely to see DM as part of identity, more open with friends, higher self care expectations, more secret non-adherence
Adolescent boys and self management of diabetes
Boys: perceive DM as a threat to masculinity, less open about condition, passing strategy-concealment, less independent, more parental involvement
What do young people with chronic conditions want from HCPs
‘Treat me as a person’
Encouragement and support
Don’t force me
Give options
Understanding
