Adherence Flashcards
(31 cards)
what is the definition of adherence?
the extent to which the patients behaviour matches agreed recommendations from the prescriber
what is the definition fo compliance?
the extent to which the patient behaviour matches the prescribers recommendations
why is compliance not used any more?
relegates the patient to a passive recipient of medical advice rather than someone involved in shared decision making
what is shared decision making?
a collaborative process that involves the person and their healthcare professional working together to reach a joint decision about care
what model can be used to help with shared decision making?
the revised three-talk model
what is the three-talk model of shared decision making?
1 - team talk - work together to describe choices, offer support, ask about goals
2 - option talk - discuss alternatives
3 - decision talk - get to informed preference
what is concordance?
the shared agreement between prescriber and patient regarding decisions which incorporates their respective view - the collaborative outcome of shared decision making
what is initiation?
when the person starts their prescribed medication
what is implimentation?
the extent to which the pt’s medicine taking behaviour aligns with the prescription
what is presistence?
the length of time between taking the first and last dose
what is discontinuation?
when the pt takes the last dose of medicine marking the end of therapy
what 4 groups are more likely to report not being involved in their care?
people with dementia
people with hearing loss
16-35 y/o
>66 y/o
what are 3 implications of non-adherence to the NHS?
Financial - wasted medicine
Can limit therapeutic benefit of medicines
can lead to increased demand at additional cost
True/False - patients who adhere to treatment have better health outcomes?
True
what is intentional non-adherence?
when the patient makes a conscious decision not to follow recommended treatments
what is unintentional non-adherence?
the patient wants to follow treatemnt but is prevented by certain factors
e.g. - forgetting, lack of understanding, practical barriers
what are the 5 domains of non-adherence?
Social and economic factors
Condition related factors
Health system/care team factors
Patient related factors
Therapy related factors
what are 5 health system/care team factors for non-adherence?
Insufficient counselling
lack of community care
lack of follow up
long wait times
poor provision of information
what are 4 patient related factors for non-adherence?
patient disagreement with necessity of treatment
fear of dependence
patient anxiety
low motivation
also visual hearing and cognitive impairment as well as swallowing problems and impaired mobility
what are 6 therapy related factors for non-adherence?
complex regimens
immediacy of beneficial effects
adverse effects
duration of treamtment
polypharmacy
frequent changes to therapy
what are 5 condition related factors for non-adherence?
level of disability
rate of progression
severity of illness
severity of symptoms
specific conditions - depression, anxiety, drug/alcohol misuse
what are 6 ways to improve communication?
adapt consultation style
ask open questions
use communication aids
consider factors that may affect communication
encourage questions
use simple language
what are 5 ways to increase patient involvement?
avoid non-verbal cues
avoid assumptions
Base decisions of benefits and risks
explain advantages and disadvantages of treatment
explain disease of condition clearly
what information should be provided to patients about their medications?
adverse effects
duration of treatment
info about how to take
likely benefits
what to do if they get adverse effects
what to do if they miss a dose
