MEDICATION ADHERENCE AND NON ADHERENCE
Medication adherence is defined by the World Health Organization as "the degree to which the person's behaviour corresponds with the agreed recommendations from a health care provider”. Medication adherence is a behavioural process that is influenced by many factors, assuming the patient has the knowledge, motivation, skills and resources to follow the health care provider’s prescription. Adherence is an important modifier of health system effectiveness
The point that separates "adherence" from "non-adherence" would be defined as that in the natural history of the disease making the desired therapeutic outcome likely (adherence) or unlikely (non-adherence) to be achieved.
Non-adherence is a problem that
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Inaccurate estimation of medication adherence can lead to several problems which are potentially costly and dangerous in both settings. Effective treatments may be judged as ineffective, expensive diagnostic procedures may be ordered, and therapy may be unnecessary and dangerously intensified. In addition, results of clinical trials cannot be realistically interpreted without adherence information. Treatment efficacy and dose-response relationships are miscalculated in studies where patients present poor adherence. Moreover, accurate estimates of medication adherence will provide better evidence on the consequences, predictors/risk factors, and strategies to improve medication …show more content…
The popularity of above features that appear in devices is ranked in descending order. Even though not all such features are available in all devices, recording adherence performance is essential for analysis and to tailor suitable
In this essay, I will be using the understanding of two psycho-social theories, the theory of planned behavior and the health belief model, and the professional ethics to explain how it can lead to the development of concordant medicines-taking behavior in Amira Masood. Concordant is which doctor, pharmacist and patient agree therapeutic decisions that including their respective opinions, to a deeper understanding which extends from prescribing communication to patient support in medicine taking. (1) I will be also discussing the issues of consent and confidentiality arising in the case. The health belief model is comprising by four basic beliefs.
According to Dr. John Steiner, a researcher at Kaiser Permanente, very few patients are fully capable of complying with all their doctors’ requests and or recommendations. To illustrate his point, he constructed a chart for a theoretical 67-year-old patient with diabetes, hypertension and high blood pressure. He then tabulated what it would take to be “adherent” with all medical recommendations: Five prescriptions to be filled monthly, getting to and from the pharmacy, (assuming he even has insurance), diet (cutting down salt and fats), exercise (three or four times per week), make it to doctors’ appointments, blood tests, check blood sugar, and on top of that, remembering to take the pills every morning and then again every evening eve...
Harm Reduction theory is an approach that was originally and successfully used when counseling HIV positive clients. When using the Harm Reduction approach during drug treatment, the counselor approaches the issue of substance abuse as a something more than just an issue to be cured. The intent of Harm reduction therapy is not to completely eliminate the client’s use of drugs, but instead focuses on minimizing the physical and mental harm that can be associated with the ongoing abuse of the given substance. The strategies used during this type of therapy emphasize management of the clients drug and alcohol use. In many cases teaching the client this type of drug management approach has been shown to reduce harm to the client, people closely involved with the client, as well as to the community. (Miller, 1996)
What are "seemingly irrelevant decisions" within the context of relapse prevention? Seemingly irrelevant decisions, also known as “set-up” are decisions an individual makes that may seem irrelevant at the time, but very often can lead to a relapse. Because these decisions seem irrelevant and because their true purpose is partly unconscious, the addict is able to argue that events had caught them off guard. Once this pattern is recognized, it becomes much harder for the addict to continue engaging in them without making conscious decisions. 2.
Medication Errors one of the biggest issues happening in an acute care setting today . Although, Medications are given based on the five rights principles: the right patient, right medication, right route, right dose, and right time. Even with the five rights principles medication errors are still happening. However, some of the errors that are occurring are due to poor order transcriptions and documentation, drug interactions, proper drug name and not paying enough attention and environment factors.
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Patients who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. There is a great need for nursing interventions in conducting a patient medication review also known as “brown bag”. As nurses obtain history data from patients at a provider visit, the nurse should ask “what medications are you taking?” and the answer needs to include over-the-counter medications as well. If the response does not include any medications other than prescribed meds, it is incumbent upon the nursing professionals to question the patient further to ensure that no over-the-counter medications or supplements are being consumed. This is also an opportunity for the nurse to question about any adverse reactions the patient may be experiencing resulting from medications. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients continuing to take medications that have been discontinued by the physician. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
This service is experienced, documented, evaluated and paid for as Pharmaceutical Care. Pharmaceutical Care consists of a philosophy of practice, patient care process as well as a patient management system. Pharmaceutical Care has common integrated vocabulary consistent with other patient care practices such as medicine, dentistry and nursing. Philosophy of pharmaceutical care consists of a description of the social need for the practice, a concise and clear statement of individual practitioner responsibilities to meet this social need, the expectation to be patient-centered and the requirement to function within the caring paradigm. This philosophy of practice is expected and practiced by all health care professionals. The patient care processes must be consistent with the patient care processes of all other health care providers. These processes include the assessment of the client’s pharmaceutical needs, a health care plan that is constructed to meet the specific needs of the client and a process in which evaluates the health care plan to gauge the efficacy of decisions made and actions taken. Pharmaceutical care management system includes all resources needed to manage the client’s needs, which include the space provided, such as a clinic or hospital, an appointment system for patients, appropriate and ethical documentation, reporting of patient care, evaluation of decisions made and actions taken and payment of service
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Elderly who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. Elderly who take over-the-counter medications, herbs, and supplements without consulting their physician are at risk for adverse reactions associated with polypharmacy. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients who continue to take medications which have been discontinued by the physician. There is a great need for nursing interventions regarding polypharmacy, including medication reviews also known as “brown bag”. As nurses obtain history data and conduct a patient assessment, it is essential to review the patients’ medications and ask open-ended questions regarding all types of medications in which the patient is taking. In addition, the patient assessment is also an opportunity for the nurse to inquire about any adverse reactions the patient may be experiencing resulting from medications. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Patients can gain a lot of information about their diseases and decide against the doctor’s treatment plan. This affects the patient’s willingness to participate and does play a role in CQI (Sollecito & Johnson, 2013). Patients are considered part of the clinical microsystem and integral to work of improvement, their safety concerns will be welcomed and acted upon (Gibson, 2007). Such as, a patient having religious beliefs may not allow them to receive a certain treatment and the doctor may have to adjust their plans per the patient’s requests. In addition, this will benefit the providers because the patient’s satisfaction will have increased if they were involved in their health outcome. Even though active patient involvement seems great, patients should walk on the side of caution as
Agyemang, REO, and A While. "Medication errors: types, causes and impact on nursing practice." British Journal of Nursing (BJN) 19.6 (2010): 380-385. CINAHL Plus with Full Text. EBSCO. Web. 7 Mar. 2011.
Patient consent is the law. Even though the test can provide unsatisfactory results they cannot anticipate the way the drugs will affect the present. This could lead to one patient favoring one treatment over another. The problem that comes from specific informed consent cannot be addressed solely by demanding more rigorous standard for research (Truog et al. 1999).
In cystic fibrosis, a genetical condition that has a high population of young patients with multiple medical treatment requirements, it is of clinical importance to ensure compliance to their treatments in order to avoid a premature death. Behavioural economics can help here by addressing how we improve motivation with and perceived value of medical treatments – to improve overall patient compliance. In treatment compliance with children, up to 70% of patients with chronic illnesses have poor adherence (Haynes RB, 2002). Poor adherence to cystic fibrosis therapies may result in increased disease symptoms, decrease physical functioning, increased time in hospital, morbidity rates and mortality, as such an increased healthcare costs (Vibeke Bregnballe, 2011). Therefore the more compliant the more cost-effective treatments become, and the healthier the patients stays. It is also important to note that for every drug skipped represents a financial loss. Capgemini group reported in 2013 that the worldwide cost of non-adherence to be estimated at 564 billion dollars. So, if we get childre...
Secondly, I would write a journal article and have it published in the pharmaceutical’s bulletin to include a well-known nursing journal. These journal articles would contain the findings of the research and suggestions on how the nursing staff can help the patients improve the compliance of taking prescribed medication.
O’Shea, E (1999) Factors contributing to medication errors: a literature review. Journal of Clinical Nursing. 8, 5,496-503.
This relationship can be successfully built in the presence of appropriate communication. The positive correlation has been found between the patients’ adherence and the good communication in various recent studies. It means that the effective communication can make the patients understand the details of their illness, get a knowledge about the steps to be taken in order to cure it and get motivation to keep up their morale (Bakken et al., 2000).