Treatment Adherance

Question 1

Adherence

Answer 1

Behaviour that optimizes therapeutic efficacy. Adhering to the physicians plan, not something that they personally have agreed.

Question 2

Compliance

Answer 2

Following a practitioner’s advice or instructions

Question 3

Concordance

Answer 3

Shared (negotiated) agreement between patient and practitioner. Discussed with patient, taking patients beliefs into account. Likely to get better outcomes. Prescribing and medicine taking based upon partnership.

Question 4

Describe examples of non-adherence and their impact.

Answer 4

Non-attendance, not taking medication, not following protocols for behaviour management

Question 5

Explain key factors responsible for non-adherent behaviour.

Answer 5

• Well established habits e.g. smoking, side-effects of medication, lack of partnership between patients and HCPs
• Professional e.g. prescribing, practical e.g. difficulty opening medication, information e.g. complicated instructions, lifestyle choices e.g. side effects or no perceived benefits, beliefs about medicine e.g. unnatural, addictive. Ask about beliefs!

Question 6

Describe a relevant model of health behaviour

Answer 6

Health belief model (need to know what the patient believes), theory of reasoned action and information, motivation, behavioural skills (MB

Question 7

Give examples of cognitive and behavioural interventions

Answer 7

Short educational video, homework (e.g. monitoring peak flow, spirometer), parental reinforcement

Question 8

Health belief model

Answer 8

Perceived susceptibility/seriousness of disease (age, sex, ethnicity, personality, socioeconomic status, knowledge) (perceived benefits vs perceived barriers to change)–> Perceived threat of disease (cues to action: education, symptoms) –> Likelihood of behavioural change