Health care advice and adherence to treatmet

Question 1

1. What is the definition of adherence?

Answer 1

a. Attachment or commitment to a person, cause or belief
b. Extent to which patient follow through decisions about medicine taking
c. Extent to which a person’s behaviour corresponds with agreed recommendations from a health care provider
d. Less than 80% of medications

Question 2

2. Define compliance?

Answer 2

a. The action or fact of applying with a wish or command

b. Extent to which patients follow doctor’s prescription about medicine taking

Question 3

3. Define concordance

Answer 3

a. Extent to which patients are successfully supported both in decision making partnerships about medicines and in their medicines taking

Question 4

What is the prevalence of non-adherence?

Answer 4

a. Acute -> chronic lifestyle diseases leading to inc in non-adherence because length of illness is longer
b. Developed countries overall average rate of adherence in long-term conditions is approx 50%

Question 5

What are the consequences of non-adherence?

Answer 5

a. Poor health outcomes
b. Inc healthcare costs
c. Inc in mortality

Question 6

1. What are the main causes of non-adherence?

Answer 6

a. Physical capability
i. To adapt to lifestyle changes
ii. Dexterity
b. Psychological capability
i. Comprehension of disease and treatment
ii. Executive function
iii. Cognitive functioning
c. Social opportunity
i. Stigma of disease
ii. Fear of disclosure
iii. Religious/cultural beliefs
d. Physical opportunity
i. Cost
ii. Access
iii. Packaging
iv. Regimen complexity
e. Reflective motivation
i. Perception of illness
ii. Beliefs about treatment
iii. Outcome expectancies
f. Automatic motivation
i. Stimuli or cures for action
ii. Depression and anxiety

Question 7

2. What leads to specific beliefs about medication and therefore adherence

Answer 7

a. Necessity (doubting it)

Concerns due to negative effect

Question 8

1. What factors affect the recall of health care information?

Answer 8

a. Order in the list
b. Personal salience of words
c. Number of words
d. Chunking/encoding strategy
e. Delay time
Distraction

Question 9

2. Why is this relevant

Answer 9

a. Give important info at beginning and end of consultation
b. Emphasise and repeat important info
c. Make salient to the person
d. Chunk information into meaningful categories
e. Avoid overloading with information

Question 10

1. How can you improve adherence to treatment?

Answer 10

a. Interventions to improve understanding of illness and treatment
b. Interventions to help patients to plan and organise their treatment
c. In the consultation
i. Provide rationale for necessity of treatment
ii. Elicit and address concerns
iii. Agree a practical plan for how, where and when to take treatment
iv. Identify any possible barriers