Treatment Adherence

Question 1

Define compliance

Answer 1

Compliance is the action or fact of applying with a wish or command

Question 2

Define adherence

Answer 2

Adherence is the attachment or commitment to a person, cause or belief

Question 3

What is the difference between compliance and adherence?

Answer 3

Compliance refers to the extent to which patients follow doctors’ prescription about medicine taking; adherence refers to the extent to which patients follow through decisions about medicine taking

Question 4

Define non-adherence.

Answer 4

When a patient’s behaviour does not correspond with agreed recommendations from a healthcare provide

Question 5

What is the prevalence of non-adherence?

Answer 5

Overall average rate of adherence is about 50%

Question 6

State some consequences of non-adherence.

Answer 6

• Increased hospital admissions (1 in 5 are because of non-adherence)
• Rejection of transplants
• Occurrence of complications
• Development of drug resistance
• Increased mortality

Question 7

What are the three main reasons for non-adherence?

Answer 7

Regime related factors (including physical aspects e.g. packaging, complexity, side effects, duration, cost etc.)
Poor doctor-patient interaction
Psychosocial variables

Question 8

What are some important factors affecting adherence?

Answer 8

Patient’s ability and resources (- unintentional non-adherence) leading to practical patient barriers to adherence
Patient’s beliefs about the treatment and illness (intentional non-adherence) leading to perceptual barriers to adherence. This regards to the patient’s beliefs on the necessity of treatment and concerns about negative side effects

Question 9

State some patient factors affecting recall of healthcare information.

Answer 9

Anxiety
Medical knowledge
Memory impairment

Question 10

State some presentation factors affecting recall of healthcare information.

Answer 10

Amount of information 
Order 
Stressing importance 
Specificity 
Mode of presentation 
Follow-up

Question 11

List some ways of improving adherence to treatment.

Answer 11

• Improve understanding of illness and treatment
• Help patients to plan and organise their treatment
• Improve the doctor-patient interaction (communication style and presentation)
• Identify and modify beliefs
• Involve significant others, wider network and potential to use assistive technology
• Use consultations
  ○ Clear rationale and necessity of drugs
  ○ Elicit and address concerns
  ○ Agree on a practical plan
  ○ Identify barriers