Adherence
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| 🇬🇧 | 🇬🇧 |
| What is the definition of Adherence | Extent to which patient behaviour coincides with medical advice |
| Difference between compliance and adherence | Compliance is the extent to which patient conforms or fulfills medical advice while adherence is the extent to which patient behavior coincides with medical advice Compliance is the passive behavoir of following a list of instructions from the doctor Adherence is more positive and proactive behavoir resulting in lifestyle change by the patient |
| What can poor adherence lead to | Worsening of disease Death Increased health care cost |
| What are some strategies to improve adherence | Raising information and skill levels Simplification of medication regimens Long-term reinforcement Education Development of dispensing aids Improved communication between the patient and health care provider |
| What are some direct ways of measuring adherence | Urine/blood test - most direct measure, but is expensive , invasive and can be effected by metabolism Observation of consumption |
| What are some indirect ways of measuring adherence | Pill counts - unreliable due to lost pills Self-report - Easy to obtain, inexpensive, but may have issues with accuracy, bias etc. Second-hand reports (doctors, carers etc.) Electronic measures of dose which record the times at which bottles are opened Repeat prescription records |
| What are some unintentional nonadherence reasons | Lack of understanding of instructions Forgetting instructions/doses Difficulty following and integrating regime into daily life Problems accessing treatment |
| What are some intentional nonadherence reasons | Beliefs Attitudes and expectations of patients Personal choices |
| Five types of non-adherence | Consistent Underdoser --> Regularly neglects to take one of the prescribed doses, such as the midday dose Regularly takes only some of the prescribed medications Consistent Overdoser --> Regularly takes a drug more often or in larger doses than is prescribed Random doser --> Takes the medications when she or he thinks of it Abrupt Overdoser --> Does not take medications properly and then takes an overdose prior to a clinic visit Doubles up for missed doses Tourist --> Abruptly stops all medications for a few days or weeks Takes one day off per week |