HealthPsych Session 8 Flashcards
What is adherence?
Extent to which pt behaviour coincides with medical advice
Is non-adherence the norm, even in conditions where it could prove fatal?
Yes
What are the outcomes of non-adherence?
Impact on pt’s health
Financial implications of wasted drugs, consultations etc
What percentage of pts with chronic illnesses are non-adherent?
50%
In what type of treatment regime are low adherence rates typically seen?
Those that include lifestyle changes
Which diseases have the highest rates of adherence?
HIV
Arthritis
GI disorders
Cancers
Which diseases have the highest rates of non-adherence?
Pulmonary disease
Diabetes
Sleep disorders
Which could have a greater impact on improving population health: improving adherence or improvement in specific medical Tx?
Improving adherence
What are the problems with measuring adherence?
Definition of adherence - do you have to take prescription exactly as prescribed for it to be effective?
Tx over a period of time so when best to assess?
Lack of consistency in measures
Difficulty of comparison of studies between different conditions with different Tx
What direct measures can be used to measure adherence?
Urine/blood test
Observation
What are the problems associated with using urine/blood tests to measure adherence?
Expensive
Limited to clinical practice
Metabolism
Non-adherence masked by adherence just prior to test
Delay in lab reports delays interventions until after point of care
What indirect measures can be used to measure adherence?
Pill counts Mechanical/electronic measures of dose Pharmacy records Pt self-report 2nd-hand reports Attendance rates for lifestyle Tx
What pt factors can influence adherence?
Understanding of information, illness and Tx
Recall of Tx and regime
Health belief model
What illness/disease factors impact adherence?
Adherence increases when pts experience symptoms
Severity of disease: pts in objectively poorer health with less serious disease more likely to be adherent, pts in objectively poorer health with more serious diseases less likely to adhere
What treatment factors can affect adherence?
Preparation - Tx setting, waiting time etc
Immediate character - complexity of regimen, duratio, degree of behaviour change
Administration
Consequences - physical/social S/E
