Public health Flashcards
What is compliance?
Older terminology which describes how well a patient sticks to the allotted medical regime. It assumes the doctor knows best and is professional focussed rather than patient focussed.
What is adherence?
Newer terminology which describes the extent to which the patients actions match the agreed medical recommendations. It is patient focussed.
Examples of non-adherence:
- Not taking prescribed medication
- Taking bigger/smaller doses than prescribed
- Taking medication without finishing the course
- Modifying treatment to accommodate other activities
- Continuing with behaviours against medical advice
What are unintentional reasons for non-adherance?
- Difficulty understanding instructions
- Problems using treatment
- Inability to pay
- Forgetting
What are intentional reasons for non-adherance?
- Patients’ beliefs about their condition
- Beliefs about treatment
- Personal preference
What is the necessity-concern framework?
This is the concept that patients adhere to prescriptions etc based on necessity beliefs and concerns:
Necessity beliefs - perceptions of personal need for treatment
Concerns - about a range of potential adverse consequences
What is the beliefs about medicines questionnaire?
A method to asses cognitive representations of medicine. One section assesses representations of the medicine prescribed and one which assess beliefs about medication in general.
Why is good doctor-patient communication important?
- Leads to higher adherence
- Better health outcomes
- High patient and clinician satisfaction
- Decrease in malpractice risk
What is concordance?
An interaction between a clinician and patient where an agreement is formed.
What are barriers to patient-clinician concordance?
- Patients not wanting to engage in discussion
- Might worry patient more
- Patient may want to be submissive
- Time/resources
- Patience choice vs evidence
What are ethical parameters which need to be considered in patient-clinician concordance?
- Mental capacity
- Decisions detrimental to patients wellbeing
- When decision is a potential threat to others
- When the patient is a child
What legislation is in place to support medical decisions when a child is involved?
Children act 1989 - child’s welfare should be paramount. When child is of sufficient understanding the medical treatment may only be given with child’s consent.
What legislation is in place to protect the public when a patients decision is a potential threat to others?
Public health act 2010 - provides a legal basis to isolate patients with an infectious disease of category 4 (bird flu, sars, tuberculosis, typhoid) or category 5 (HIV, AIDS)