Along with the monitoring of outcome, these tools assist investigators in studying medication adherence. Although biochemical measures of compliance are attractive for the sake of accuracy, there are also some problems.
This may be why non-adherence is so high. An enormous amount of research has resulted in the development of medications with proven efficacy and positive benefit-to-risk profiles.
Riboflavin, for example, can be added to medication as a method of tracking its use. Of the articles retrieved, those that did not address CVD, medication adherence, or health literacy in the abstract were excluded, leaving for inclusion in the review.
Health Beliefs; competing social and cultural concepts of disease and treatment, inappropriate or conflicting health beliefs. Factors contributing to poor medication adherence are myriad and include those that are related to patients eg, suboptimal health literacy and lack of involvement in the treatment decision—making processthose that are related to physicians eg, prescription of complex drug regimens, communication barriers, ineffective communication of information about adverse effects, and provision of care by multiple physiciansand those that are related to health care systems eg, office visit time limitations, limited access to care, and lack of health information technology.
For example, smokers can be detected by studying carbon monoxide in their blood or exhaled breath. To assess general aspects of medication adherence using cardiovascular disease as an example, a MEDLINE-based literature search January 1,through March 31, was conducted using the following search terms: For example, these measures often produce misleading findings.
Self-monitoring, in which the patient keeps a written record of regimen activities, such as the foods eaten each day. For through not taking disagreeable drinks, purgative or other, they sometimes die.
If the people with epilepsy felt that the medication was impairing their ability to handle routine social activities, they modified the medication to reduce this impact.
Besides complexity, an important treatment characteristic is the actual length of the treatment regimen. However doctors are notoriously poor at determining whether or not their patients have used medications. This is more true for particular types of medications such as tranquilizers and sleeping pills.
He believes the following factors are important: Obviously the type and nature of the treatment being offered will have a significant impact on how likely patients are to adhere. It was concluded that patiences are less likely to adhere if the side effects costs outweigh the benefits of a treatment of problems that are mostly asymptomatic — in this case, hypertension.
Rather, they referred to social side effects.
Personal Characteristics; type and severity of psychiatric disorder, forgetfulness, lack of understanding. Thus we can conclude that the more satisifed a patient is with their relationship with their doctor, the more willing they are to adhere to the medical advice given.
Researchers also looked at the use of written information in improving compliance. However, we seem to have forgotten that between the former and the latter lies medication adherence: Therefore we can conclude that non- compliance is a rational process whereby the individual carefully adjusts the medication to maximize its impact.
Cited in Kaplan et al, posted by b3 at 5: However, simultaneously the medication was seen as a daily reminder that they had epilepsy.
Johnson and Bytheway Previous research shows that older people are more likely to buy over-the-counter without prescription medication.
However, for those who claim that they have used the medication as prescribed, these verbal reports are often not confirmed by objective records Spector et al.
There are other biochemical by-products that can be studied. There are also a variety of different problems that can lead to inaccurate assessments. Contingency contracting, whereby the practitioner and client negotiate a series of treatment activities and goals in writing and specify rewards the patient will receive for succeeding.The treatment of chronic illnesses commonly includes the long-term use of pharmacotherapy.
Although these medications are effective in combating disease, their full benefits are often not realized because approximately 50% of patients do not take their medications as prescribed. Compliance Following Medical Advice 13 Factors Affecting Adherence disease was strongly related to compliance.
That is, the objective severity of a disease is less closely related to adherence to medical recommendations concerning treatment or prevention than the threat that people experience from a disease.
Thus we can conclude that the more satisifed a patient is with their relationship with their doctor, the more willing they are to adhere to the medical advice given.
An additional point is that the more understanding the physician of the patient's belief system, the more compliant the patient is. adherence We need to consider why people do not adhere to medical advice, this section will look at patients who make a rational decision not to adhere.
There is also the question of how to improve adherence and how to measure adherence. Why patients do and don't adhere to advice Research has shown that it is not the patient's personality that predicts non-adherence, but a combination of factors arising out of the doctor - patient relationship (e.g.
Ley ). Why patients do not adhere to medical advice. Bradley () Bradley () found evidence to support the view that patients can be aware of their glucose levels: Some diabetics were very accurate at.Download