Features of Adherance

Question 1

BULPITT 1988

Background

Answer 1

There are many reasons as to why people don’t adhere to medical regimes such as the characteristics of the illness or medication, socio-demographic variables (age, gender, culture), cognitive, social and emotional factors.

Question 2

BULPITT 1988

Aim

Answer 2

To review research on adherence in hypertensive patients.

Question 3

BULPITT 1988

Method

Answer 3

Review article

Question 4

BULPITT 1988

Procedure

Answer 4

Reviewed research identifying problems with taking medication with significant side-effects for hypertension(high blood pressure). Statistical analysis of physical and psychological effects of adherence to medication for hypertension including work, physical well-being, hobbies and personal life.

Question 5

BULPITT 1988

Results

Answer 5

Anti-hypertension medication can have the effect of sleepiness, dizziness, lack of cognitive functioning and lack of sexual functioning in men.
Curb at all (1985) found 8% of patients dropped out due to sexual problems.
Research by Medical Research Council (1981) found that as much as up to 15% dropped out due to problems arising from side effects.

Question 6

BULPITT 1988

Conclusion

Answer 6

When the costs of taking medication, such as side effects, outweigh the benefits of treating a mainly asymptomatic problem such as hypertension, there is likelihood of the patients not adhering to the treatment.

Question 7

LUSTMAN 2000

Background

Answer 7

Number of methods to measure adherence to medical regimes such as self report, pill counts, therapeutic outcome or biochemical tests.

Question 8

LUSTMAN 2000

Aim

Answer 8

To see if there was a link between depression and non-adherence in diabetic patients medication.

Question 9

LUSTMAN 2000

Method

Answer 9

Randomised controlled double blind study.

Question 10

LUSTMAN 2000

Participants

Answer 10

60 patients with type 1 or 2 diabetes and diagnosed with depression. Volunteers.

Question 11

LUSTMAN 2000

Procedure

Answer 11

Randomly assigned to either one group given fluoxetine(used to treat depression) or group given identical pill but was a placebo. Patients and doctors didn’t know which group they were in.
Assessed for depression using psychometric tests and assessed their adherence to diabetic regime by blood sugar levels.

Question 12

LUSTMAN 2000

Results

Answer 12

After 8 weeks group given fluoxetine had healthier blood glucose level, reported lower levels of depression and had lower levels of GHb(indicating improved adherence).
Patients who reported less depressive symptoms more regularly monitored their blood glucose levels.
If depression is medicated they were more likely to adhere to diabetic regime.

Question 13

LUSTMAN 2000

Conclusion

Answer 13

Measuring blood sugar levels in patients with diabetes indicates their levels of adherence to medical regimes. Greater adherence was shown by patients who were less depressed.
Not being anxious or depressed improves compliance with medical requests.

Question 14

WATT 2003

Background

Answer 14

Adherence to medical regimes should be improved to prevent the burden on the NHS and to stop wastage of medication.

Question 15

WATT 2003

Aim

Answer 15

To see if using a Funhaler can improve children’s adherence to medication for asthma.

Question 16

WATT 2003

Method

Answer 16

Field experiment

Question 17

WATT 2003

Participants

Answer 17

32 Australian children aged 1.5-6 years. All asthmatic, full parental consent given.

Question 18

WATT 2003

Procedure

Answer 18

Repeated measures design. Each child given normal ‘breath-a-tech’ for a week and then parent answered a questionnaire. Second week given Funhaler and parents given a similar questionnaire with matched questions.

Question 19

WATT 2003

Results

Answer 19

38% more parents were found to have medicated their children the previous day when using Funhaler compared to existing treatment.

Question 20

WATT 2003

Conclusion

Answer 20

Previous research had given reasons for non-adherence such a boredom, forgetfulness and apathy. Funhaler set out to remedy this by reinforcing correct usage of the inhaler with a spinner and whistle. This did improve adherence to the medication so by making the regime fun adherence, certainly in children, can be improved.