Adherence

Aim: This is a review article of studies aimed at finding correlations between patients' non­-adherence to medical treatment and their levels of anxiety and depression.

Sample: 25 studies carried out between 1968 and 1998, 12 of these were about depression and 13 about anxiety.

Method: In order to qualify for this review, previous studies had to measure adherence and patient depression or anxiety and involve patients who were not being treated for depression or anxiety, but had been asked to follow a medical regime by a doctor who was not a psychiatrist.

Results: The studies examined by the authors showed that there seems to be no correlation between anxiety and non-adherence, but a strong correlation between depression and non-adherence.

Conclusions: Compared with non-depressed patients, depressed patients are three times more likely to fail to adhere to the medical regime that has been prescribed for them.

Aim: To investigate ethnic differences in adherence to the American Food Guide Pyramid recommendations. A natural experiment.

Participants: Over 115,000 people, aged 45-75 years, from three different ethnic groups: white Americans (21,933 men, 25,303 women), Japanese Americans (25,893 men, 28,355 women) and Native Hawaiians (5979 men, 7650 women). quota sample and informed consent was obtained.Procedure: A questionnaire (the Food Frequency Questionnaire - FFQ) was designed specifically for this study. It was standardized on a sample of 60 men and 60 women, aged 45-75 years, from each of the three ethnic groups prior to use in the study. The foodstuffs on the list covered more than 85 per cent of the intake of fat, dietary fibre, vitamin A, carotenoids and vitamin C, as recommended by the Food Guide Pyramid, and were measured in servings, which were then converted to daily calorie intake (measured in kilocalories, or kcal).

Results: First, data from each individual ethnic group were compared with the daily recommended intake for each of the foodstuffs contained in the American Food Guide. It was found that there was little variation between the ethnic groups and their adherence to the recommendations of the American Food Guide. No one ethnic group adhered to the recommendations more than any other. It was also found that those with the highest daily calorie intake (more than 2800kcal per day), again irrespective of ethnicity, consumed more than three times as much alcohol, discretionary fat and added sugar than those with a calorie intake of less than 1600kcal per day.

There were some differences between the ethnic groups, however. The Native Hawaiian group had the highest daily calorie intake of the three groups. Japanese American men ate two more servings per day of the grain food group than white men.

Aim: Find a objective way to measure adherence,Compare self-report with electron monitoring of patients with high blood pressure

Sample:286 18-84 50% black, 33% black 67 % middle class

Method:ask questions on socio statu, adherence, medication, health status, health beliefs,social support. Montoired for 3 months,ahrence questions but didn'tknow they were being electrically montoried.

Results: 21 said they missed doese but 42 % acutallymeet them- they were of social economic status and had a lower pecieved health risk

Conclusions:Patients to over estimate or over doses, so measurements are hard to know if they are vaild or reliable.