Bulpitt - Adherence To Medical Regimes Flashcards
Aim
To investigate adherence in hypertensive patients
Method
Review article of research into problems with taking drugs for high blood pressure.
Findings
1: Anti-hypertension medication can have many side effects
Eg. Dizziness, CAUSE SEXUAL PROBLEMS.
This unacceptable level of side effect is a major factor causing patients to withdraw from treatment.
2: Curb - 8% males discontinued treatment because of sexual problems.
3: Medical research council trail for 5 years found 15% withdrawn taking medicating due to gout, impotency and lethargy.
4: 9% discontinued for definite side effects, further 23% for possible side effects
5: Effect cognitive functioning, therefore work and hobbies curtailed as ability to function effectively decreased. Effects depend on drug. More prevalent in elderly as blood pressure drops when standing or moving about.
6: Being tired may effect hobby or relaxation activities.. Making movements and concentration more difficult. 27% from study in Germany said hypertension interfered with hobbies eg, walking, gardening and reading
Conclusion
When costs of taking medication outweigh the benefits there is less likelihood of patient adhering to the treatment.
Rational choice not to take due to sexual side effects.
SUPPORTS HBM AND COGNITIVE APPROACH.
Non adherence
Do not take medication or follow medical advice.
Irrational behaviour as cannot see or feel the change.
Rational non-adherence
Positive decision not to take the medication
Rather than just forgetting.
MAKE A CHOICE (maybe based on HBM - costs outweigh the benefits).
Hypertension
Asymptomatic… No obvious symptoms eg. High blood pressure
Therefore increase likelihood for rational non-adherence.
Procedure
Wellbeing of participants with high blood pressure… Looks at:
Affect on quality of life and it’s complications.
Other associated illnesses eg. Depression.
Treatment prescribed.
Sexual problems
Side effect of anti-hypertension drug, erectile problems leading to impotence. Significant cost to men and do not want to take.
Symptoms got worse
Sleepiness, diarrhoea and male sexual dysfunction.
Symptoms got better
Headaches, unsteadiness and depression
Reliability
Cross referencing of studies increases reliability and generalisability.
Based on a range of research and provides cumulative evidence.
Useful
- researchers can look at patterns over time of research for different studies, and how attitudes to medication and adherence change over time.
- help doctors understand how best to promote medicalisation if we understand why people are less likely to adhere.
Validity
Data collected should be much more controlled and questionnaires properly validated.
Eg. Increase control by double blind to treatment patient is getting.
Review study = not clear how studies were selected and whether they were representative of all research or whether they were chosen to fit Bulpits views.
Holistic
Quality of life approach takes into consideration the side effects of therapy (sexual dysfunction), psychology well being (other associated illness - depression/anxiety), and work/leisure performance.
This is because it looks at physical and psychological side effects.
