NBSS: (behaviour) Adherence to Treatment

Question 1

what is non-adherence?

Answer 1

the extent to which a person’s behaviour corresponds with agreed recommendations from a healthcare provider

Question 2

what is compliance?

Answer 2

extent to which someone’s behaviour matches prescriber’s recommendation

Question 3

what is concordance?

Answer 3

agreement reached after negotiation between a patient and a healthcare professional during the consultation - more about relationship between patient and consultant

Question 4

what is adherence?

Answer 4

alternative to compliance → patient is free to decide whether to follow or not and failures to do so should not be blamed on patient, emphasises need of agreement

Question 5

what is treatment?

Answer 5

• taking medications
• attending follow-up outpatient apps
• lifestyle changes
• clinical tests

Question 6

how is adherence measured?

Answer 6

• self report questionnaires
• self monitoring (diary)
• pill counts
• frequency of dispensing
• mechanical measures (microchips in bottle tops)
• biochem indicators (blood/urine)
• proxy measure (clinical or other symptoms)

Question 7

what is the treatment for asthma?

Answer 7

• reliever (blue) treatment immediate effect
• anti-inflammatory of preventer (steroid, brown) is delayed = less easily perceived

Question 8

what are the two types of non-adherence?

Answer 8

• unintentional non-adherence
• intentional non-adherence

Question 9

what two factors contribute to practical barriers for unintentional non-adherence?

Answer 9

• capacity/functional limitations
• resource limitations

Question 10

what is intentional non-adherence?

Answer 10

• deliberate and intentional choice to/not to take medication as prescribed
• logical decision based on the information available and the weight the patient places on that information
• does not take all doses as prescribed/take too much/ wrong time

Question 11

what are the myths of how adherence be fixed?

Answer 11

• providing info
• providing reminders
• being authoritative
• fear arousal

Question 12

According to the World Health Organisation, approximately what percent of patients fail to take their prescriptions as prescribed by their doctors?

A: 10%
B: 25%
C: 50%
D: 80%

Answer 12

C

Question 13

Sarah has been in remission from breast cancer for 1 year. She has been prescribed tamoxifen for 5 years to reduce the risk of recurrence. Sarah has discontinued her medication as she finds the side-effects of the drug difficult to manage. What is this behaviour described as?

A: Non-compliance
B: Non-persistence
C: Intentional non-adherence
D: Unintentional non-adherence
E: Poor necessity beliefs

Answer 13

C

Question 14

A patient who sometimes experiences severe asthma attacks is prescribed a preventer inhaler to reduce their risk of attacks. Though the inhaler is prescribed daily the patient only uses it when they are feeling unwell. What should the health care professional do to try to improve adherence?

A: Provide information about the severity of their asthma
B: Provide reminders to use the inhaler
C: Discuss their level of social support
D: Discuss their resource limitations
E: Discuss their treatment perceptions

Answer 14

E