Healthy Living - Features of Adherence

Question 1

What was the aim of Bulpitt’s study?

Answer 1

To review research into adherence in hypertensive patients.

Question 2

What was the method of Bulpitt’s study?

Answer 2

A review article.

Question 3

What was the procedure of Bulpitt’s study?

Answer 3

Statistical analysis of physical and psychological effects of adherence to medication for hypertension. (work, physical well being, hobbies, personal life)

Question 4

What were Bulpitt’s results?

Answer 4

• Anti-hypertension medication can cause sleepiness, dizziness and sexual functioning problems, as well as cognitive functioning.
• Curb et al (1985), 8% of patients dropped out due to sexual problems.
• Medical research council (1981) - 15% dropped out as a result of side effects.

Question 5

What conclusions were made from Bulpitt’s review article?

Answer 5

When the costs of taking a medication, e.g side effects, outweigh the benefits of treating an asymptomatic condition/problem, patients are less likely to adhere.

Question 6

What were the strengths of Bulpitt’s study?

Answer 6

+ Concurrent validity - conclusions drawn from analysing multiple pieces of research which all agree with each other

+ Qualitative data - deep understanding can be gained about the reasons people adhere or not.

+ Holistic - many different side effects considered to have an effect on an individual’s likelihood to adhere.

Question 7

What were the weaknesses of Bulpitt’s study?

Answer 7

• Review article - lower validity - second hand research makes it less useful.
• Complete and comprehensive information about studies analysed not included, which decreases reliability.
• Reductionist - reduces adherence down to 2 variables - whether the condition is asymptomatic and whether the side effects are intrusive or not.

Question 8

What was the aim of Lustman’s study?

Answer 8

To see if there is a link between depression and non-adherence.

Question 9

What was the method in Lustman’s study?

Answer 9

Randomised controlled double blind study.

Question 10

What was the sample in Lustman’s study?

Answer 10

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

Question 11

What was the procedure of Lustman’s study?

Answer 11

• Patients assigned to one group out of two. One group treated with fluoxetine (drug for depression), other given placebo.
• Patients were assessed for depression using psychometric tests and adherence to diabetic treatment regime assessed by measuring blood sugar levels.

Question 12

What were the results of Lustman’s study?

Answer 12

• After 8 weeks the group given the fluoxetine had much healthier blood glucose levels. Patients who reported less depressive symptoms monitored their blood sugar levels more regularly.
• Patients given fluoxetine reported lower levels of depression and lower levels of GHb, showing their improved adherence.
• Patients more likely to adhere to their diabetic regime if their depression was being medicated.

Question 13

What conclusions can be made from Lustman’s study?

Answer 13

Measuring blood sugar levels in patients with diabetes indicated their level of adherence to prescribed medical regimes.

• Greater adherence was shown by patients who were less depressed.
• Not being anxious or depressed improves compliance with medical requests.

Question 14

What were the strengths of Lustman’s study?

Answer 14

+ Supports psychology as a science - measurement of diabetes compliance - GHb levels in blood accurate and reliable.

+ High ecological validity - patients left for 8 weeks in ‘real world’.

+ Low researcher bias/demand characteristics –> results more valid.

Question 15

What was the aim of Watt et al’s study?

Answer 15

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

Question 16

What was the method of Watt et al’s study?

Answer 16

Field/Quasi Experiment

Question 17

What was the sample in Watt et al’s study?

Answer 17

• 32 Australian children aged 1.5 - 6 years old.
• 10 boys, 22 girls.
• All diagnosed as asthmatic

Question 18

What was the procedure of Watt et al’s study?

Answer 18

Repeated measures design: inhaler used for a week and then a questionnaire given to parents at the end of the week asking if the child had taken their medicine the day before.

Question 19

What were the results of Watt et al?

Answer 19

38% more parents were found to have medicated their children the previous day when using the fun-haler, compared to the normal treatment.

Question 20

What was concluded from Watt et al’s study?

Answer 20

Reinforces the idea that boredom, forgetfulness and apathy were reasons for non-adherence in children - adherence can be improved in children by making the medical regime fun.

Question 21

What were the strengths of Watt et al’s study

Answer 21

+ Repeated measures design - negates effect of individual differences.
+ High Ecological validity - PPS were free to do whatever they liked during the experiment.
+ Useful - practical applications of how adherence can be improved.

Question 22

What were the weaknesses of Watt et al’s study?

Answer 22

• Low control over extraneous variables mean less able to establish cause and effect relationships.
• Self report measure means data collected is subject to social desirability bias.
• Low sample size and ethnocentric - only 32 children and all Australian.