Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Block 9 Week 2 > Treating HTN HB- Kohlenberg > Flashcards

Treating HTN HB- Kohlenberg Flashcards

1
Q

Approximately (blank) of patients do not take medications as prescribed

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T or F

Medications adherence is exclusively the responsibility of the patient

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T or F

Increasing adherence may have a greater effect on health than improvements in specific medical therapy

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Statins and antihypertensives have adherence rates below (blank)
(blank) percent do not fill initial statin prescription

A

50%.

58%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is primary adherence?

A

do they fill the prescription

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Antihypertensive therapy can reduce risk of stroke by (blank) and MI by (blank). As many as (blank) percent of patient treated for HT are nonadherent to their treatment regimen.

A

30%
15%
50-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

WHO says lack of (blank) is the most important cause of failure to achieve BP control

A

adherence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Within 6 months to 1 year after being prescribed statins, (blank) percent of patients discontinue them.
At 2 years, (blank) percent of patients discontinue them.

A

25-50%

75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which of these drugs has the worst adherence? the Best adherence?

  • antihypertensive therapy
  • statins
  • antiplatelet therapy
  • warfarin
A

warfarin
antihypertensive

from best to worse
Antihypertensive> antiplatelet> statins> warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is compliance?

A

Implies that the patient passively follows the doctor’s orders and that the treatment plan is not based on a therapeutic alliance or contract established between patient and physician.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is adherence?

A

a collaborative model, with health care providers having some responsibility in creating the tx contract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some patient related factors that cause poor medication adherence?

A

Lack of understanding, lack of involvement, poor medical literacy.
In US, 90 million adults have poor health literacy
Health beliefs
Costs, transportation, support (a big problem with mood disorders and CVD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What age group has the worst adherence?

A

older people; 20% of pnts over the age of 65 are adherent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

(blank) is the greatest risk factor associated with increased incidence of HF in the elderly.

A

Medication nonadherence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T or F

Women are more nonadherent than men with antihypertensive medications

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are physician related factors to non adherence?

A
  • physicians fail to recognize nonadherence (worse estimates when patient is high functioning)
  • overly complex drug regiments, ineffective communication
  • poor communication amongst physicians (discharge summaries are available at less than 34% of first post discharge visits)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are health system factors related to non adherence?

A

Costs
lack of time
fragmented systems
poor coordination

18
Q

What are strategies to improve medication adherence?

A 
Educated well (patients recall as little as 50% of what is said)
Empower patients (motivation and adherence will increase)
Motivational Interviewing
Avoid complicated regimens
19
Q

Since not all people are health literate so what should you do to get patients to adhere ?

A

Make sure they understand, make sure they can read, simplify things, make it a shame free environment, recognize mental illness, tune into economic status

20
Q

T or F

adherence is improved when a good relationship exists between patient and doctor

A

T

21
Q

Patients reporting low ratings of patient-centered communication and trust with their personal clinician had (blank) worse nonadherence rates to medication refills compared with patients reporting high ratings after adjusting for clinical and sociodemographic characteristics.

A

7% to 16%

22
Q

What is the cost of having diabetes per month?

A

$440.45

23
Q

What are good questions a clinician can ask to assess a patient’s medication adherence?

A
  • I know it must be difficult to take all your medications regularly. How often do you miss taking them?
  • Of the medications prescribed to you, which ones are you taking?
  • Have you had to stop any of your medications for any reason?
24
Q

How can you reduce complexity?

A
  • limit pharmacy visits
  • adhere to formulary (an official list giving details of medicines that may be prescribed), respect economic realities
  • reduce number of pills per day
25
Q

What are ways the health system could help with adherence?

A
  • phone reminders
  • starting long term meds during hospital visit rather than after discharge may improve adherence.
  • Med reconciliation (a list of all meds, including name, dose, frequency, route and comparing it with transfer/discharge orders)
26
Q

A study with acute coronary syndrome patients had an intervention that utilized med reconciliation and tailoring, patient education, collaborative care b/w PCMD or cardiologist and pharmacist, 2 types of VM, educational and reminders. What did the results of this study show?

A

Improved adherence by 7% but did not improve clinical targets

27
Q

Another study looked at patients with uncontrolled HTN, the intervention counted pills, family member was designated to support adherence behavior, education support to patients. What was the outcome?

A

Improved adherence (48 to 32%) but did not improve long term CV events

28
Q

A study assessing primary adherence (prescription refilling) showed that if give a patient an automated phone reminder, they will (blank) their adherence

A

double

29
Q

What happened in this study:

gave a bunch of obese people free gym memberships

A

Didnt help

30
Q

What happened in this study:

conventional care vs house education program

A

no difference

31
Q

What is early nonpersistance?

A

filling

32
Q

What is nonadherence?

A

not having meds available for 20% or more days during 12 month following initiation of therapy

33
Q

A study looked at different racial/ethnic differences in adherence, what did it show?

A

Non whites were more likely to exhibit early nonpersistence and nonadherence

It showed that health strategies such as reduced copays, ease of access to meds (mail order) and optimizing the choice for initial therapies narrow the gap.

34
Q

(blank) are disproportionally affected by hypertension, and it explains most of the racial gap in mortality.
Poor medication adherence may explain poor BP control.

What can increase this adherence?

A

African Americans
Increased Positive affect (increased positive affect induction, self affirmation, look or positive feelings, unexpected gifts, induction of positive feelings)
PA is more effective than patient education!!!!!

35
Q

In women, (blank) accounts for more than 50% of cardiac death

A

sudden cardiac death (SCD)

36
Q

(blank) percent of SCD may be attributed to unhealthy lifestyle. How can you reduced this?

A

dont smoke, BMI less than 25. exercise 30 min per day or more, med, diet.
79%

37
Q

(blank) is the most important factor in determining adherence to tx.

A

communication

Less time spent with the patient discussing meds is a strong predictor of lower adherence

38
Q

What BMI do you want? How much exercise?

A

BMI less than 25

30 min per day or more

39
Q

What is the spirit of MI?

A
  • working together on a problem
  • inspire, draw forth motivation from the person
  • respecting people’s choices, their resources, whether or not they change
40
Q

What is the PACE acronym for the spirit of motivational interviewing stand for?

A

Partnership
Acceptance
Compassion
Evocation

41
Q

MI supports the patient in (blank)

A

articulating
(how personally important this change e.g dietary) is, as opposed to how important we think it is
What stands in the way of making this change (time, money, cultural factors, etc)
Changes that might work in their life
How to increase the chance of success

42
Q

What are the four general techniques for motivational interviewing?

A

-express empathy
-develop discrepancy
-rolling with resistance (reflect, listen, validate)
-supporting self-efficacy
(less likely to make change if people don’t think they can. Build hope and confidence)

Block 9 Week 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions