Health psychology - Adherence Flashcards
Steps in adherence?
- Acceptance
- Adoption
- Initiation
- Treatment continuation
Acceptance (step 1 adherence), depends on:
- Readiness for change
- Patient preference
- Trust in provider
- Level of burden imposed
- Consistency of the advice
- Satisfaction
Adherence (definition)
The extent to which a person’s behavior corresponds with agreed recommendations from a healthcare provider
Consequences of non-adherence
Poor(er) treatment outcomes
More complications
More physician visits
More hospital admissions
Increased health care costs
Decreased quality of life
Different types of non-adherence
Intentional & non-intentional
Intentional non-adherence
Patients consciously decide not to adhere to the advice (e.g. creative non-adherence = patients modifies the scheme of the proscribed medication)
Non-intentional non-adherence
Patients unconsciously do not adhere to the advice
Steps in adherence:
- Acceptance
- Adoption
- Initiation
- Treatment continuation
Acceptance (step 1 adherence)
Depends on:
- Readiness for change
- Patient preference
- Trust in provider
- Level of burden imposed
- Consistency of the advice
- Satisfaction
Adoption (step 2 adherence)
Factors influencing adoption (barriers):
- Cost
- Accessibility
- Availability
Initiation (step 3 adherence)
Treatment is not initiated or is discontinued after brief exposure:
- Too difficult to adhere
- Immediate side effects occur
Treatment continuation (step 4 adherence)
Adherence may vary across time (e.g. people may sometimes miss a dose of the medication)
Measuring (non)adherence
Electronic monitoring (= gold standard)
Questionnaire
Daily diaries
Drug concentration in blood sample
Prescription refills
Pill counts
Adherence determinants
- Socio-economic factors
- Healthcare team and system-related factors
- Condition related factors
- Treatment-related factors
- Patient-related factors
