Adherence to Medical Regime Mind Map
- Created by: Adam Stern
- Created on: 03-11-13 16:08
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- Adherence to Medical Regime
- Measures of Adherence
- Lowe and Raynor
- Self Report
- Becker
- Self Report
- Blood Validity Test
- Lustman et al
- Physiological Method
- Chung and Naya
- Mechanical Mehod
- Therapeutic Outcomes
- Looking at whether drug has been effective
- Most common
- Not always the case that strict adherence = positive outcome
- Physiological Method
- Not always possible with all conditions
- Self Report
- Social Desirability and Demand Characteristics possible
- Lowe and Raynor
- Reasons for Non-adherence
- Rational Non-adherence
- Costs of adhering outweigh benefits
- Examples
- Practical Barriers
- Social Difficulties
- Cost
- Unpleasant side effects
- Treatment not working
- Practical Barriers
- Believe it's not in their best interests to adhere
- Cowpe's Chip Pan Fire Study
- Self-Efficacy Beliefs
- Extent to which we believe we are capable
- Becker's Health Belief Model
- Cost-Benefit Analysis
- Perceived Seriousness and vulnerablity
- Dannenberg
- Low adherence despite a law in place
- Bulpitt et al
- Study on males with hypertension
- Long term linked with heart disease/strokes but asymptomatic in short-term
- Side effects such as erectile dysfunction
- Therefore males rationally decide NOT to take meds
- Side effects such as erectile dysfunction
- Cost of side effects outweigh long term benefits of lower blood pressure
- Qualitative approach providing insight
- Lowe and Raynor
- Assess extent to which intentional non-adherence is present in elderly patients
- 161 patients from general practise
- 76 years old
- 33% Male
- 71% living alone
- Interviewed using structured questionnaire at home
- Responses compared to medical records
- Questioned about discrepancies
- Responses compared to medical records
- Results
- 28 cases = admin error
- 3 cases = patient confusion
- 55 cases = rational decision to alter meds
- Conclusions
- Elderly patients made a rational decision est on cost-benefit analysis in 1/3 of cases
- Most frequently side effects or adjustment according to symptoms
- Rational Non-adherence
- Improving adherence
- Behaviorist Approach
- Methods
- Modelling
- Direct Reinforcement
- Contingency Contracts
- Patients negociates contract with healthcare worker concerning goals and rewards for achievement
- Feedback and Self-Monitoring
- Punishment
- Methods
- Watt et al
- Leys et al and Banyard
- Found patients forget most info given by doctors
- If doctors trained to structure given info and write down instructions adherence rates can be improved (Particularly in the elderly)
- Simons et al
- Suggests reasons for not taking statins are largely irrational
- May be open to intervention to improve adherence rates
- Suggests reasons for not taking statins are largely irrational
- Health Belief Model
- Demographic Variables such as Gender are useful
- Behaviorist Approach
- Measures of Adherence
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