Treatment adherence, or the degree to which therapist–client dyads participate in the specified approach, has been one way of ensuring that treatments are delivered with fidelity (Sharpless & Barber, 2009; Webb, DeRubeis, & Barber, 2010).
Full Answer
Does adherence to treatment matter in primary care settings?
Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings.
How do patients'perceptions of their physicians influence patient adherence to treatment?
In addition to attitudes and sociocultural norms, patients' perceptions of their physicians are also very good predictors of patients' intentions to adhere.
How can we improve patient adherence?
The first step toward improving patient adherence involves accurately assessing whether or not patients have followed the treatments recommended to them. The precise estimation of patient adherence is not easy, and a full understanding of whether and why any given patient chooses and is able to adhere is often elusive.
Do patients with chronic diseases have adherence to medications?
Nonetheless, study’s strengths rest in the assessment of overall adherence in patients with chronic diseases rather than adherence to one single condition or particular drug therapy. We have considered a number of common chronic conditions and evaluated several factors using the WHO conceptual framework.
Why is adherence to treatment important?
Taking your medicine as prescribed or medication adherence is important for controlling chronic conditions, treating temporary conditions, and overall long-term health and well-being. A personal connection with your health-care provider or pharmacist is an important part of medication adherence.
What is treatment adherence therapy?
Adherence therapy (AT) is an intervention that seeks to reduce patients' psychiatric symptoms by enhancing treatment adherence. We aimed to systematically review the trial evidence of the effectiveness of AT on improving clinical outcomes in these patients.
Why is medication adherence importance in mental health?
Patients who maintain the correct medication regimen more effectively manage their mental health symptoms and improve their emotional well being. The willingness to take medication also indicates patients' confidence in the entire treatment process and the development of skills needed for living in recovery.
What are three 3 strategies you can use to develop a therapeutic relationship with a client with a mental illness?
Some strategies that may help include:Help the client feel more welcome. ... Know that relationships take time. ... Never judge the client. ... Manage your own emotions. ... Talk about what the client wants from therapy. ... Ask more or different questions. ... Don't make the client feel rejected. ... Refer to another therapist.More items...•
What is the difference between patient compliance to treatment and patient adherence to treatment?
Compliance is a passive behavior in which a patient is following a list of instructions from the doctor." The article continues, noting, "Adherence is a more positive, proactive behavior, which results in a lifestyle change by the patient, who must follow a daily regimen, such as wearing a prescribed brace.
Why do patients not comply with treatment?
Lack of trust: If for whatever reason, you don't believe your treatment is going to make a difference in your health, you may not be motivated to comply. Apathy: When you don't realize the importance of the treatment, or you don't care if the treatment works or not, you are less likely to comply.
What are counseling techniques that have the potential to improve adherence?
Psychoeducation, cognitive-behavioral therapy, and motivational interviewing have all positively influenced medication adherence and combinations of these approaches may bring about better results than one approach alone.
How can we improve adherence to treatment?
Nine Tips for Improving Medication AdherenceEducate patients about what to expect. ... Nurture relationships with patients. ... Team up with prescribers. ... Engage the staff. ... Learn about and use available technologies. ... Help patients customize their support tools. ... Schedule appointments. ... Synchronize medications.More items...•
How do you encourage medication compliance in a psychiatric patient?
Here are five best practices that mental health professionals should incorporate into their medication noncompliance intervention strategies:Practice empathy. ... Find out the patient's attitude toward medication. ... Employ a shared decision-making (SDM) care model. ... Show patients long-term medication adherence is a good thing.More items...•
How important is the relationship between therapist and client?
Patients' ratings of their relationship with the therapist, even very early in the treatment — after the first session or two — predict their improvement over the course of treatment. However, patients who report poor relationships with their therapists are more likely to drop out of treatment early.
What are the 5 components of the therapeutic relationship?
The five key components of the therapeutic nurse-client relationship are professional intimacy, power, empathy, respect and trust. Regardless of the context, length of interaction and whether the nurse is the primary or secondary care provider, these components are always present.
Which of the following is a key element of the therapeutic relationship?
Which of the following is a key element of the therapeutic relationship? systematic desensitization.
What are the factors that affect adherence to treatment?
Several factors such as comorbidities, cognitive impairment, psychosocial issues, financial condition, adverse drug effects, and communication with the physicians may affect the adherence to treatment in older PD patients (Schlenk, Dunbar-Jacob, & Engberg, 2004 ). Adverse effects of drugs and higher expenses related to multiple medications may prompt the older patients with PD either to discontinue the medications or to reduce the dose. Active communication with the health care provider is of immense importance in such scenarios. The physicians must also look for other causes of nonadherence to treatment especially the nonadherence secondary to comorbidities. For example, patients with disturbance of memory may find it difficult to remember the exact schedule of medications. A study by Schlenk et al. has revealed that forgetting to take medicines is the most commonly reported reason for nonadherence ( Schlenk et al., 2004 ). Similarly, presence of depression has also been described as a risk factor for nonadherence to treatments in patients with PD. DiMatteo and colleagues have reported poor adherence to medication is three times more likely in patients with depression compared to those without depression ( DiMatteo, Lepper, & Croghan, 2000 ). Hence such comorbidities affecting adherence should be properly addressed in elderly PD patients. Adequate counseling and collaborative approach including the participation of nurse practitioners, social workers, pharmacists may help in improving the adherence to treatment. Use of several adherence aids such as weekly pillboxes, and hour-by-hour organizational charts may improve the treatment adherence in elderly PD patients ( Park, Morrell, Frieske, & Kincaid, 1992 ).
Why is adherence to diet so poor?
Such poor adherence often arises because patients do not have the necessary behavioral skills to make changes to their diet. Following a heart attack, e.g., patients might well understand the importance of changing their lifestyle but are unable to make the suggested changes. There will be other circumstances in which patients might not understand the importance of suggested changes and may even believe that the recommended changes pose an additional risk to their health. Indeed, motivational interviewing seeks to elicit the ambivalence patients have about making changes, the source of which may be inaccurate or emotionally based perceptions. In still other circumstances, patients might be experiencing depression or anxiety, such that emotional dysfunction will be a major barrier to adherence. In addition, a longitudinal study demonstrated that adherence to the dietary intervention protocol declined steadily even during the intervention period as the frequency of contact declined, which suggests that it is difficult for participants to sustain the behavior changes without ongoing reinforcement [158].
What is behavior therapy for kids?
Thus, behavior therapy with children is a constantly evolving form of treatment, which continually draws upon new findings from empirical research for the development and refinement of therapeutic interventions. In its early incarnations, behavior therapy with children was limited to relatively simplistic applications of basic experimental learning theory to circumscribed behavior problems. However, fueled by increased evidence of its effectiveness, behavior therapy has evolved into a more comprehensive and complex, yet mainstream therapeutic approach, with widespread applicability to a variety of children's mental health and behavioral problems. Behavior therapy with children continues to expand its purview to encompass broader social problems with a greater sensitivity to developmental processes of youth.
How is treatment adherence related to clinical outcomes?
Clinical outcomes are directly related to treatment adherence, which in turn is related to resource utilization and to the economic burden of mental illness. Adherence with psychiatric treatments is associated with better outcomes, a lower relapse rate, improved adherence with treatment regimens for nonpsychiatric illness, and lower rates of hospitalization.6–8 Nonadherence has been associated with a greater risk of psychiatric hospitalization, use of emergency services, arrests, violence, victimizations, lower mental function, lower life satisfaction, and more prevalent use of substances. 9 Rates of suicidal ideation are significantly greater among patients who are treatment nonadherent following hospitalization. 5
Why is medication adherence important for older adults?
Adherence to medication regimens is particularly important for older adults with serious mental illness (SMI, e.g., schizophrenia, bipolar disorder). It is well known that psychiatric medication compliance is a major factor in relapse for those with SMI, and that late-life presents a unique set of challenges for this population with regard to adhering to proper medication schedules. Deliberate medication non-adherence may be less of a problem for older adults with SMI; unintentional non-adherence may be more of a problem (Depp & Lebowitz, 2007). That said, the mental health care system has a history of being less than collaborative in treatment planning and implementation, with forced or mandated treatment for many with serious mental illness. Partnership in treatment planning may be far more effective in increasing treatment adherence.
What are the barriers to medication adherence in patients with CKD?
There are numerous factors that make adhering to the medication, dietary, and behavioral treatments for CKD challenging. Polypharma cy and regimen complexity are two significant obstacles to medication adherence in patients managing chronic illnesses including CKD. 66,67 Polypharmacy and regimen complexity may present particular challenges for elderly patients who may have concurrent cognitive decline.
What is flooding in psychology?
Typically, flooding involves both exposure to a feared stimulus and a response prevention component. In other words, once exposed to the stimulus, clients are prevented from responding with escape or avoidance behaviors. It was believed that allowing clients to avoid focusing on the anxiety or to escape the flooding situation prior to anxiety reduction would only increase anxiety symptoms. Prevention of escape or avoidance behaviors was once considered the hallmark of flooding procedures. However, more recent research has suggested that exposure alone may be as effective as exposure with response prevention.
Introduction
Tuberculosis (TB) is a widespread infectious disease which is caused by Mycobacterium tuberculosis. According to the World Health Organization (WHO) estimating, about 10.0 million people (range, 9.0–11.1 million) diagnosed with new TB cases worldwide in 2018.
Methods
This cross-sectional multi-center survey was done between June 20, 2019, and August 31, 2019. Four medical institutions in Dalian, northeast China were involved in this study. The four medical institutions, which served different types of patients, were chosen according to their institution level and location.
Results
Among the 564 participants, there were about twice as many male patients (66.31%) as female patients (33.69%). The mean age was 47.41 years and the median was 49 years. Most of the participants were married (71.10%), and only 93 (16.49%) were migrants. There were slightly more rural patients (52.66%) than urban patients (47.34%).
Discussions
With a high prevalence of TB in China, researchers have carried out various studies on the treatment outcome of TB, while few studies have focused on the treatment effect in the medication process even though each TB patient has to take anti-TB medicine chronically. This was the first study on treatment effects among the TB patients in China.
Conclusions
This study explored the predicting role of treatment adherence, doctor–patient trust and communication in treatment effects, and the difference between urban and rural TB patients. The urban TB patients reported better treatment effects than the rural ones.
Abbreviations
TB, tuberculosis; SEM, structural equation model; WHO, World Health Organization; CFA, confirmatory factor analysis; F.L., factor loading; CR, composite reliability; AVE, average of variance extracted; DPT, doctor–patient trust; DPC, doctor–patient communication; TE, treatment effect; DF, degree of the freedom; CFI, comparative fit index; TLI, Tucker-Lewis index; RMSEA, root mean squared error of approximation; SRMR, standardized root mean square residual; CI, confidence interval; S.E., standard error; Est, estimate..
Acknowledgments
We thank all 15 interviewers, who came from the School of Public Health at Dalian Medical University, for their efforts in collecting the data. In addition, we are grateful to all the medical personnel from the four investigative districts who contributed to our study. Finally, we express gratitude to the TB patients who made our study possible.
How to Establish a Healthy Therapeutic Alliance
All therapists require a depth of relating with their clients. In Cognitive-Behavioral Therapy ( CBT ), this may be described as a close relationship, while for person-centered and experiential therapy, it is considered core to the treatment (Knox & Cooper, 2015).
Components of the Therapeutic Relationship
There are several crucial factors and components to building and maintaining a therapeutic relationship.
2 Examples of a Supportive Therapeutic Alliance
A supportive therapeutic alliance is crucial to client perseverance and a positive treatment outcome (Ardito & Rabellino, 2011).
10 Skills of Effective Therapists
International research about what makes a great therapist explored what such professionals were doing, thinking, and feeling when they were at their most effective (Novotney, 2013).
3 Helpful Techniques for Counselors
There are several techniques that counselors can adopt to improve the therapeutic relationship.
6 Communication Tips
When the therapeutic alliance appears to fail, it is worthwhile considering your approach to communication (Knox & Cooper, 2015).
Assessing Your Relationship: 2 Questionnaires & Scales
Client feedback can help therapists recognize psychological distress and improvements to wellbeing (Knox & Cooper, 2015).
Abstract
Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings.
Background
The increase in life expectancy and the aging of the world population have been paralleled by an alarming growth in the global burden of chronic conditions [ 1 ]. Chronic diseases are generally considered physical or mental conditions that last more than a year and require ongoing care.
Methods
A cross-sectional study was conducted in two primary healthcare centers between August 2016 and March 2017 in Soria, an urban city of 39,000 inhabitants located in the autonomous community of Castile and Leon, Spain.
Results
Among the 344 eligible patients randomly invited to participate in the study, 41 (11.9%) refused to participate and 4 (1.2%) withdrew during the interview process. The characteristics of the excluded subjects were similar to those of the overall group.
Discussion
To our knowledge, this is the first attempt to determine factors associated with adherence under the WHO multidimensional framework in patients with chronic conditions in primary care settings in Spain.
Conclusions
Adherence to long-term treatments for chronic conditions remains a challenging issue in primary care. A low proportion of patients followed the recommendations from healthcare providers which underlines the need of reinforcing medication adherence in primary care. Our results should help to design new interventions aimed to enhance adherence.
Availability of data and materials
Data will be available upon reasonable request from the corresponding author.