WEEK 5

Question 1

Define concordance

Answer 1

An approach to prescribing that aims to achieve a therapeutic alliance between doctor and patient, with the goal of achieving the best use of medicines compatible with what the patient desires and is capable of achieving

Question 2

What is the consultation approach relating to concordance?

Answer 2

Patient-centred approach

Question 3

Define compliance (full/partial)

Answer 3

The extent to which the patient follows mutually agreeable instructions/extent to which actual drug taking behaviour matches the prescribed regimen

Question 4

Define adherence

Answer 4

Similar to compliance but there is a stronger assumption that the regimen was discussed and agreed, differing it from the patient just being obedient

Question 5

What are two forms of non-adherence?

Answer 5

Intentional and unintentional

Question 6

Define intentional non-adherence

Answer 6

Where the patient makes a conscious decision not to take the prescribed medicine

Question 7

Define unintentional non-adherence

Answer 7

Situations in which the patient intends to take the medicine but does not do so (e.g. by forgetting or not understanding how to take it)

Question 8

What are five patient information needs about medication?

Answer 8

1) Side effects
2) What it does/what it’s for
3) Do’s and don’ts
4) How to take it
5) Supply of medication

Question 9

What are three forms of formal information sources?

Answer 9

1) Health professionals
2) Consumer Medicine Information (CMI)-leaflet
3) Pharmaceutical websites

Question 10

What are two forms of informal information sources?

Answer 10

1) Electronic media (internet and television)

2) Non-expert help (such as family and friends)

Question 11

What are the two polar types of consultations?

Answer 11

‘Patient-centred’ and ‘doctor-centred’

Question 12

What are 3 characteristics of a patient-centred approach to consultations?

Answer 12

1) Facilitates patient participation and fosters relationship of mutuality
2) Greater use of ‘open’ questions
3) Doctors spend more time actively listening to patients’ problems/feelings

Question 13

What are 4 characteristics of a doctor-centred approach to consultations?

Answer 13

1) Assumption that doctor is the expert and the patient merely co-operates
2) Focus on the physical aspects of disease
3) Questions are mainly of a ‘closed’ nature
4) Provides little opportunity for patients to express their own beliefs and concerns

Question 14

Why would using a patient-centred approach encourage greater concordance?

Answer 14

Patients’ concerns relating to adherence are better addressed and therefore reassurance of worries can be given