Session 6: Adherence & Homeless Healthcare

Question 1

What is compliance?

Answer 1

Extent to which patient complies with medical advice (doing what they’re told by the doctor)

Question 2

What is adherence?

Answer 2

Extent to which a person’s behavior corresponds with agreed recommendations from a health care provider (more patient centred)

Question 3

What are 6 examples of non adherence?

Answer 3

1. Not picking up medication
2. Stopping medication before completed course
3. Taking more or less meds
4. Taking meds at wrong time, missing doses
5. Taking some but not all meds
6. Not implementing lifestyle changes

Question 4

What are 2 consequences of non adherence?

Answer 4

1. Health benefits forgone (worse quality of life, more hospitalizations, premature mortality)
2. Wider economic burden (personal, health and social cost)

Question 5

What are the 2 types of non adherence?

Answer 5

Unintentional and intentional

Question 6

What is unintentional non adherence?

Answer 6

Patients want to follow their treatment but are prevented from doing so by barriers outside of their control

Question 7

What is intentional adherence?

Answer 7

Patient decides not to follow treatment regime based on their beliefs, attitudes and expectations

Question 8

What are 5 examples of unintentional non adherence?

Answer 8

Poor recall of instructions
Poor comprehension of instructions
Difficulty in administering treatment
Inability to afford
Forgetting

Question 9

What are 3 interventions to improve adherence?

Answer 9

1. Educating patient on medicine to increase their knowledge
2. Simplifying regime
3. Making it easier to remember

Question 10

Why do people intentionally not adhere to treatment?

Answer 10

1. Beliefs about illness (severity, understanding of illness as chronic or episodic)
2. Beliefs about medication (necessity, harmful effects, stigma, concerns about conflict with activities, tolerance, masking symptoms)

Question 11

What are the 5 factors of the model of adherence?

Answer 11

Patient - beliefs and understanding, memory
Illness - symptoms, severity
Treatment - preparation, side effects, complexity, stigma
Psychosocial - social support, psychological health
Healthcare - setting, dr pt interaction, communication

Question 12

What are health needs of the homeless population?

Answer 12

1. Illnesses that lead to premature death
2. Difficulty in gaining access to a GP
3. Mental health issues
4. Substance abuse

Question 13

What are 6 intervention categories to provide good health care for the homeless population?

Answer 13

Pharmalogical
Psychosocial 
Case management
Disease prevention
Housing & social determinants
Women & youth specific