ADHERENCE TO MEDICAL ADVICE

Question 1

What are the types of non adherence

Answer 1

Failure to follow treatments, Failure to attend appointments

Question 2

Failure to follow treatment can be broken down into three different types

Answer 2

Primary non adherence, non- persistence

Question 3

What is rational non adherence

Answer 3

Rational non-adherence refers to the patient making a reasoned decision due to undertaking a cost-benefit analysis.  It seems too costly to adhere.  It is a complex interaction of a number of factors. A number of issues can be considered including the level of severity of the illness side effects (both long and short-term).

Question 4

Aim of Laba et al

Answer 4

to find out which factors contribute the most to rational non-adherence to investigate whether factors relating to specific medicines and patient background contribute to non-adherence.

Question 5

Laba et al Result

Answer 5

Monthly cost was a significant factor but only for those without private medical insurance most participants (58%) considered harms to be of greater importance than benefits when making decisions about adherence.

Question 6

What are the factors in the health belief model

Answer 6

Perceived severity, Perceived barriers

Question 7

What is the Health belief model

Answer 7

This model aims to predict when a person will engage in preventative health measures such as changing their diet stopping smoking

Question 8

Examples of Subjective measures in measuring non- adherence

Answer 8

Clinical interviews, Semi- structured interviews

Question 9

Examples of objective measures in measuring non- adherence

Answer 9

Medical dispensers, Pill counting

Question 10

Examples biological measures in measuring non- adherence

Answer 10

blood samples, urine samples

Question 11

Which example study is mentioned in subjective measures of non- adherence

Answer 11

Riekert and Drotar

Question 12

Which example study is mentioned in objective measures of non- adherence

Answer 12

Chung and Naya ( 2000)

Question 13

What was the aim of Riekert and Drotar ( 1999)

Answer 13

They wanted to examine the implications of non-participation in studies using self report.

Question 14

What did Riekert and Drotar find

Answer 14

This does demonstrate that those who take part in such self-report studies ARE more likely to be adherers and so distort this type of study.

Question 15

What was the aim of Chung and Naya ( 2000)

Answer 15

This was the first study to electronically assess compliance with an oral asthma medication. Aimed to see if patients did take their medication regularly and at the correct time of day.

Question 16

what did Chung and Naya find

Answer 16

the study showed that compliance was consistently high throughout the 12 weeks of treatment and adherence

Question 17

What was the aim of the Yokley and Glenwick (1984) study?

Answer 17

To evaluate the effectiveness of four different conditions for motivating parents of preschool children to get their children immunised.

Question 18

What was the sample the Yokley and Glenwick study?

Answer 18

2101 immunisation deficient preschool clients (aged five and under) at a public health clinic in an American city.

Question 19

Describe the ‘general prompt group’ in the Yokley and Glenwick (1984) study.

Answer 19

Families were mailed a prompt with general immunisation information urging parents to get their children’s immunisations up to date

Question 20

Describe the ‘specific prompt group’ in the Yokley and Glenwick (1984) study.

Answer 20

Families were mailed a prompt that named the target child listed the specific immunisations required

Question 21

What additional information did the ‘increased access group’ receive in the Yokley and Glenwick (1984) study?

Answer 21

They received the specific prompt along with extra out-of-hours sessions at the clinic childcare facilities

Question 22

What was offered to the ‘monetary incentive group’ in the Yokley and Glenwick (1984) study?

Answer 22

A specific prompt and information about a cash lottery with cash prize draws requiring a ticket submission upon receiving the immunisation.

Question 23

What were the dependent variables in the Yokley and Glenwick (1984) study?

Answer 23

Number of target children receiving one or more immunisations number of target children attending the clinic for any reason

Question 24

How did the monetary incentive group perform compared to other groups in the Yokley and Glenwick (1984) study?

Answer 24

The monetary incentive group had the biggest impact on immunisation rates.

Question 25

What was the most cost-effective intervention according to the Yokley and Glenwick (1984) study?

Answer 25

The specific prompt was the most cost-effective intervention.

Question 26

What does reductionism refer to

Answer 26

Understanding complex behaviours by breaking them into simpler factors or aspects often without considering broader contexts.

Question 27

What individual and situational factors may influence behaviour according to the Yokley and Glenwick (1984) study?

Answer 27

Individual factors like personal traits and situational factors like environmental cues can explain behaviour.

Question 28

How accurate were the specific prompts in the Yokley and Glenwick (1984) study?

Answer 28

93% of the specific prompts in a random sample of 10% were found to be completely accurate.

Question 29

waht was Laba et al about

Answer 29

Factors contributing to rational non- adherence

Question 30

How many children participated in Yokley & Glenwick's 1984 study?

Answer 30

2101 immunization-deficient preschool children participated.

Question 31

What was the average number of immunizations needed per child in the study?

Answer 31

The mean number of immunizations needed was 5.2 per child.

Question 32

What types of interventions were used in the study?

Answer 32

General prompt, specific prompt, increased access, monetary incentive

Question 33

What were the control groups in the study?

Answer 33

One control group received a phone call requesting information (contact control) and the second received no contact (no-contact control).

Question 34

Which intervention had the greatest impact on increasing immunization rates?

Answer 34

The monetary incentive group had the biggest impact on immunization rates.

Question 35

Which interventions produced a 29% increase in immunizations?

Answer 35

The specific prompt and monetary incentive interventions each produced a 29% increase.

Question 36

Which intervention was considered most cost-effective?

Answer 36

The increased access (expanded hours with free childcare) intervention was considered the most cost-effective.

Question 37

What major conclusion did the study draw for health departments?

Answer 37

The study suggested that community intervention programs can increase immunization rates and can be used effectively by health departments.

Question 38

What is a strong feature of the study's design?

Answer 38

Large-scale sample (2101 children)

Question 39

Why is the validity and reliability of the prompts in this study considered high?

Answer 39

Prompt accuracy was high and their delivery was consistent throughout the study.

Question 40

What is one limitation regarding the generalizability of this study?

Answer 40

Results may not generalize beyond preschoolers aged 5 or under and other locations since the study took place at a single urban American clinic.

Question 41

What is a real-world application (RWA) of the study?

Answer 41

The findings can influence public health policy and the design of community health intervention programs.