Intro to non-adherence to medical advice

Question 1

What is adherence?

Answer 1

• The degree to which a patients behaviour
• Corresponds with the recommendations of a health care provider.

Question 2

What is non-adherence?

Answer 2

• When the patients behaviour does NOT correspond with agreed recommendations from a health care provider.
• Due to patient beliefs and preferences.

Question 3

Can you name 2 main types of non-adherence

Answer 3

1. Failure to FOLLOW treatments
2. Failure to ATTEND appointments

Question 4

Failure to follow treatment can be broken down into three different categories. Can you name them?

Answer 4

1. Primary non-adherence
2. Non-persistence
3. Non-conforming

PNN

Question 5

Can you define primary non-adhernence

Answer 5

• When the DR prescribes medication, but it is never collected.

Question 6

Can you define non-persistence?

Answer 6

• When a patient begins to take medication but stops without medical advice.
• Often unintentional (due to misunderstandings, difficulties with clost, access, forgetting

Question 7

Can you define non-conforming?

Answer 7

• Medication is not taken in the perscribed way (missing doses, incorrect times, incorrect doses)

Question 8

Can you name 3 consequences of failing to attend appointments?

Answer 8

1. Waste of medication: Medication not taken= Economic consequences
2. Time lost: Due to missed appointments = HCW could be looking after ppl who need care.
3. Impact on medical research: If courses of treatment are not followed, researchers cannot move forward with research

Question 9

Can you name 4 other consequences of failing to attend appointments?

Answer 9

1. Progression of illness: (Likely)
2. .Increased use of medical resources: Patient may require hospitalisation, more invasive treatments.
3. Reduced functional abilities: Untreated n illness may debilitate patients ability to function= unable to work/care for others.
4. Lower quality of life: Symptoms will worsen, so will QOL.

Question 10

Can you name some negative effects of (medicine) non-adherence?

Answer 10

1) Increased hospital readmission
2) Increased disease progression and complications
3) Increased health care costs
4) Decreased quality of life
5) Patient death

Question 11

Taylor (1990) suggested…

Answer 11

93% of patients fail to adhere to some aspect of their treatment.

Question 12

Why may some patients non-adhere?

Answer 12

Rational non-adherence

Question 13

What is rational-non adherence

Answer 13

• When patients do not adhere to medical advice after making a rational judgements
• e.g find that there are more costs/risks than benefits of the treatment.