Health - Healthy Living - Features of Adherence to Medical Regimes

reasons for non adherence

measures of non adherence

improving adherence using behavioural methods

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Bulpitt (1988)

Aim: to review research on adherence in hypertensive patients

Method: review article of research identifying problems with taking drugs for HBP

Procedure: research analysed to identify the phsyical and psychological effects of drug treatment on a person's life. These included work, physical well-being, hobbies etc.

Key results: Anti-hypertension medication can have many side effects, including physical reactions such as sleepiness, dizziness, lack of sexual functioning. they also affect cognitive functioning, so work and hobbies are curtailed.

Conclusions: when the costs of taking medication, such as side effects, outweigh the benefits of treating a mainly asymptomatic problem such as hypertension, there is less likelihood of the patient adhering to treatment 

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Bulpitt (1988)

COGNITIVE/INDIVIDUAL DIFFERENCES

Evaluation Points:

  • determinism vs. free will
  • individual vs. situational

Method issues:

  • second hand data - may not be reliable
  • socially desirable answers

helps us find explanations for why people are different. useful applications for doctors when researching and prescribing medication.

ethnocentric, not sure about the sample from the original study-may not be reliable. ignores emotion and free will

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Lustman (2000)

Aim: to assess the efficacy of the anti-depressant Fluoxetine in treating depression by measuring glycemic control

Method: randomised controlled double-blind study

Sample: 60 patients with type 1 or 2 diabetes and diagnosed with depression

Procedure: patients randomly assigned to either Fluoxetine or placebo group. assessed for depression using psychometric tests and their adherence to their medical regimen measured by measuring GHb levels, which indicated glycemic control

Key Results: patients given Fluoxetine reported lower levels of depression. also had lower levels of GHb, indicated their improved adherence.

Conclusions: measuring GHb in patients with diabetes indicates levels of adherence to prescribed medical regimes. greater adherence shown by patients who were less depressed. previous research suggested that reducing depression may improve adherence to diabetic patients

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Lustman (2000)

COGNITIVE/INDIVIDUAL DIFFERENCES

Evaluation Points:

  • determinism vs. free will
  • individual vs. situational

Method issues:

  • second hand data - may not be reliable
  • socially desirable answers

helps us find explanations for why people are different. useful applications for doctors when researching and prescribing medication.

people may act upon what they are being asked - demand characteristics. ignores emotion and free will

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Watt (2003)

Aim: to see if using a Funhaler can improve childrens adherence to taking medication for asthma

Method: Field experiment (quasi as it uses children with asthma). 2 conditions, self-report to measure adherence rates

Sample: 32 Australian children, 10b 22g, ages 1-6. all diagnosed with asthma given prescribed drugs. parents gave consent

Design: Repeated measures. one week using Breath-A-Tech and the other week using Funhaler.

Procedure: ^ parents given questionnaires to fill in at the end of each week. Funhaler has incentive toys, function best with deep breathing pattern.

Key results: 38% more parents found to have medicated children previous day when using funhaler, compared to existing treatment

Conclusions: previous research given reasons for non-adherence - boredom, forgetfulness and apathy. Funhaler toys improved adherence to medication

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Watt (2003)

PHYSIOLOGICAL/COGNITIVE/BEHAVIOURIST

Evaluation Points:

  • reductionism vs. holism
  • individual vs. situational

Method issues:

  • less control of extraneous variable, can't be sure changes in DV are due to changes in IV
  • Sampling can be a problem, may be prescribed with asthma but may not be true

substantial evidence for what is being tested. helps us understand behviour which would not be possible to test any other way.

reductionist - explains all behaviour as a reaction between chemicals. can not explain how the mind and body interact

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