Factors Affecting Patient Adherence to Treatment

Classified in Medicine & Health

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Barlow and Ourand

21 year old who would think the worst whenever minor symptoms were experienced

Common Features Showed

  1. fear of aging and death
  2. presenting medical records in great detail
  3. especially concerned with one organ system

Factors that May Help Develop This

  1. serious illness in childhood
  2. past diseases in family members
  3. psychological stressors
  4. highly sensitive to pain

Possible Ways Patients May Not Adhere Properly

Before Treatment: poor description of treatment / lack of awareness
During Treatment: take +/- of a medicine / take at different time / not complete instructions
After Treatment: may end earlier / may fall back to certain behaviors

Why Patients May Not Adhere

Patients: decide don't need treatment / doesn't understand treatment / demographic factors
Treatment: expensive / time consuming / access isn't easy
Health Care Provider: doctor doesn't stress importance / doesn't give enough details

Why is Adherence a Problem

studies showed half of the patients with chronic illness such as diabetes or hypertension are non-compliant with regimen

Sackett 1976

  • 50% of patients in America didn't take prescribed meds as told
  • when compliance means giving up habits and going against motives, compliance is worst

Mckenny 1973 Hypertension

  • 50 patients for 7 months after detection of high blood pressure only 50-70% sought treatment
  • only 65% of pills were taken
  • only 20% of patients took 90% of pills
  • 33% of those sought treatment dropped

Becker 1972

  • looked at whether a prescribed antibiotic was being taken halfway through a 10-day treatment program in young children
  • over 50% of mothers had stopped giving meds

Why Patients Don't Adhere

rational choice theory (not adhere for a good reason)
  1. believe treatment isn't working
  2. side effects are unpleasant or affect the quality of lives
  3. there are practical barriers to the treatment such as cost or social difficulties



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