Types Of Non Adhernace And Side Effects Flashcards
What is adherence to medical advice?
The ability of a patient to follow specific guidance from a health professional.
Define non-adherence.
The failure to follow the advice from a health professional such as not taking medication or following a treatment plan.
What are some reasons patients may not adhere to medical advice?
Poor relationship with their doctor, poor communication, time constraints, and costs.
What are the potential consequences of non-adherence?
Severe consequences, which can be fatal in some instances.
What are the two types of non-adherence discussed?
- Failure to follow treatments
- Failure to attend appointments
What percentage of medications prescribed are thought to be not taken correctly or not taken at all?
A third to half of all medications.
What are the costs of not taking medication?
Both personal and economic costs.
What are the two categories of reasons for failure to follow treatments?
- Intentional
- Unintentional
What is unintentional non-adherence?
When a patient wants to follow a treatment but faces barriers not in their control.
Give examples of barriers that can lead to unintentional non-adherence.
- Not remembering or understanding what the doctor said
- Inability to afford treatment
- Taking time off work
- Simply forgetting
What is intentional non-adherence?
When a patient deliberately decides not to follow a treatment.
What factors may contribute to intentional non-adherence?
- Beliefs or preferences of the patient
- Levels of motivation
- Not believing they need the treatment or that it will work
What are the six intentional factors that can influence a patient’s decision-making according to Laba et al. (2012)?
- Immediate medication harms.
- Long-term medication harms.
- Immediate medication benefits.
- Long-term medication benefits.
- Financial cost of medication.
- Regime for taking the medication.
What factor was rated as the most important in adherence by Laba et al. (2012)?
The ability of the medication to reduce the risk of death.
What are some reasons health professionals should understand for patients failing to follow a treatment plan?
Understanding the reasons can enable interventions to help increase adherence levels.
What intervention could be made if cost is an issue for patients?
Efforts could be made to reduce the cost of the medication for those who cannot afford health insurance.
How can complex medication regimes be simplified for patients?
Providing literature that explains the regime in an easy-to-follow way might help increase adherence.
What can improve patient adherence regarding potential side effects of medication?
Making patients aware of ways to cope with or treat potential side effects may improve adherence.
What approach should practitioners take to understand patient adherence?
A holistic approach is important to understand the complex reasons behind non-adherence.
What is the estimated rate of non-attendance for appointments worldwide?
Rates of non-attendance are thought to be between 5 and 39 percent.
How many appointments are missed each year in England according to NHS data in 2019?
Up to 15 million appointments are missed every year.
What is the estimated cost of missed appointments to the NHS in England?
The cost is around £216 million pounds.
What was a strong predictor of future failure to attend (FTA) behavior?
A previous failure to attend an appointment.
What other predictors of FTA were identified?
Age (either young or over 80 years old) and work commitments.
What are some predictors of failing to attend (FTA) appointments?
Age (either young or over 80 years old), work commitments, difficulties in getting to the hospital, feeling that the appointment is unnecessary, being too ill to attend, fear or mistrust of hospitals, and fear of discovering a serious illness.
Example: Feeling better may lead to the perception that the appointment is unnecessary.
What factors did Parsons et al. (2021) find to be commonly reported for missed appointments?
Work or family commitments, forgetting the appointment, and transportation difficulties.
What demographics are most likely to miss appointments?
Individuals younger than 21, those of low social status/class, individuals who have missed appointments previously, those with a mental or physical diagnosis, and minority ethnic groups.
What are the personal and economic costs of non-adherence?
Missed appointments can lead to unresolved medical problems, making patients more vulnerable. Economically, they cost health services millions, wasting resources that could improve health.
What can result from not adhering to treatment?
It can lead to the need for further, more expensive treatment, such as surgery if a patient fails to take preventative heart medication.
How can understanding non-adherence be applied to everyday life?
By recognizing cost and complexity as factors, strategies can be implemented to lower costs or clarify instructions, leading to more effective health service strategies.
What is a strength of the nomothetic approach to non-adherence?
It benefits society as a whole and is ethical, as increased adherence can decrease financial waste.
What issue is encountered in health services related to appointments?
Lost appointments lead to a misallocation of resources, preventing funds from reaching areas in need.
What is a weakness of explanations regarding health service adherence?
They may not account for cultural differences among populations.
Which groups are more likely to not adhere to health services?
Minority ethnicities, individuals of low social status, and the young are more likely to not adhere.
Why is it difficult to generalize health service research findings?
Studies often focus on individual countries and do not consider differences in health services, such as cost.
What is a strength of research in understanding appointment attendance?
It considers both individual and situational explanations for why patients may fail to attend.
What is an example of an individual explanation for missing an appointment?
Fear or distrust of hospitals, or limited mobility in older patients.
What is an example of a situational explanation for missing an appointment?
A parent missing an appointment due to childcare issues.
How can practitioners gain insight into appointment attendance?
By considering both individual and situational explanations for failure to attend.
