Understanding and recall of healthcare advice and adherence to treatment

Question 1

Define non-adherence.

Answer 1

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

Question 2

What is the prevalence of non-adherence?

Answer 2

Overall average rate of adherence is about 50%

Question 3

State some consequences of non-adherence.

Answer 3

Poor health outcomes
Increased healthcare costs 
examples:
Increased hospital admissions (1 in 5 are because of non-adherence)  
Rejection of transplants  
Occurrence of complications  
Development of drug resistance  
Increased mortality

Question 4

What are the three main reasons for non-adherence?

Answer 4

1. Regime-Related Factors – including physical aspects e.g. packaging, complexity of regimes, frequency of schedule, duration, cost, side-effects etc.
2. Poor Doctor-Patient Interaction
3. Psychosocial Variables

• Beliefs about illness and treatment are the strongest factors affecting adherence.

Question 5

State some patient factors affecting recall of healthcare information.

Answer 5

Anxiety
Medical knowledge
Memory impairment

Question 6

State some presentation factors affecting recall of healthcare information.

Answer 6

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

Question 7

List some ways of improving adherence to treatment.

Answer 7

1. Ask the patient
2. Simplify the regime and packaging
3. Improve the doctor-patient interaction (communication style and presentation)
4. Identify and modify beliefs
5. Involve significant others, wider network and potential to use assistive technology

Question 8

Define adherence

Answer 8

attachment or commitment to a person, cause, or belief”

Question 9

Define compliance

Answer 9

the action or fact of applying with a wish or command”

Question 10

Describe the difference between compliance, adherence and concordance

Answer 10

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; and concordance refers to the extent to which patients are successfully supported both in decision making partnerships about medicines and in their medicines taking