Health - 4

Question 1

What was the range of non-adherence found by Donovan and Blake 1992

Answer 1

15-93%

Question 2

What does adherence tend to be higher in

Answer 2

In individuals experiencing more severe illness items

Question 3

What is the problem with measuring non adherence as a self report

Answer 3

Would a patient actually admit non adherence ?

Question 4

What is the problem with measuring non adherence with therapeutic outcome

Answer 4

Even non adherents will get better

Question 5

What is the problem with measuring non adherence with health worker estimates

Answer 5

Drs incorrectly predicted adherence 41% of the time (Patterson et al 2000)

Question 6

What is the problem with measuring non adherence with pill counts

Answer 6

Just beachside pull is gone does not mean it is consumed

Question 7

What is the problem with measuring non adherence with electronic methods

Answer 7

The data recorders in pull bottles are expensive and should be reliable, but patient can remove pull and not consume

Question 8

What is the problem with measuring non adherence biochemical tests

Answer 8

The blood and urine tests are time consuming and expensive and there are lots of confounds

Question 9

What are the 3 types of non adherence identified by Donovan and Blake

Answer 9

Rational - deliberately non-adherent

Unwitting - not your fault, a misunderstanding

Erratic - forgetful or you run out

Question 10

What is non-adherence

Answer 10

The process in which the patient actively decides not to use treatment or follow treatment recommendations

Question 11

What did sarafino et al find was a reason we rationally decide not to adhere

Answer 11

Side effects - unpleasant or undesirable side effects

Believe treatment is not working

Practical barriers - cost

Question 12

What is the reason vlasnik found as to why we decide not to adhere

Answer 12

Multiple physicians - decrease patients confidence in prescribed treatment

Question 13

What reason did apter et al 2003 find was a reason we deceive not to adhere

Answer 13

Fear of dependence - fears of addictive behaviour and adverse side effects

Question 14

What reason did lim and ngah find was a reason to decide not to adhere

Answer 14

Religious beliefs - may have a preference for natural remedies

Question 15

Why may a reason Eaton give the pharmaceutical company as a reason for non adherence

Answer 15

As they do not want that pharmaceutical company to make any profit or benefit in any way

Question 16

What is a non deliberate reason for adherence

Answer 16

Memory - the patient may not be able to recall what they have been told

Question 17

What did ley et al find in 1979 when asking patients to recall a series of statements presented in two ways

Answer 17

Recall was 25% better for structured info, also better for info presented at beginning of consultation

Question 18

What did Sokol et al 2005 find with the relationship between adherence and risk for hospitalisation in diabetes patients

Answer 18

More non-adherence related to greater overall cost

Question 19

Describe the study of Searle et al in 2008 with diabetic patients and foot ulcers

Answer 19

Qualitative approach- interviews asking patients why they did not adhere
15% of all diabetics develop Foot ulcers and can months or years to heal and 1/5 undergo amputation
The treatment it is elevated foot, antiobiotics and simple wound care

Question 20

Why in searles study did patients not adhere to wearing the footwear

Answer 20

Uncomfortable

Difficulty walking

Question 21

Why in Searles study did patients not adhere to foot rest

Answer 21

Patients doing foot rest boring, frustration and impractical