Firstly, non-compliance could have a major effect on treatment outcomes and direct clinical consequences. Non-compliance is directly associated with poor treatment outcomes in patients with diabetes, epilepsy, AIDS (acquired immunodeficiency syndrome), asthma, tuberculosis, hypertension, and organ transplants (Sabaté 2003).
Full Answer
What are the factors that influence the choice of Medicine?
A total of 33 factors were identified. The most frequent factors were patients' clinical condition, pharmaceutical industries, physician attributes, patient preference and cost of medicine. Conclusion
What are the factors that contribute to poor compliance to therapy?
On the contrary, misconceptions or erroneous beliefs held by patients would contribute to poor compliance. Patient’s worries about the treatment, believing that the disease is uncontrollable and religious belief might add to the likelihood that they are not compliant to therapy.
What are the four categories of factors that influence patient behavior?
Category Factors Patient-centered factors Demographic Factors: Age, Ethnicity, Gender, Education, Marriage Status Psychosocial factors: Beliefs, Motivation,Attitude Patient-prescriber relationship Health literacy Patient knowledge Physical difficulties Tobacco Smoking or alcohol intake Forgetfulness History of good compliance
Why don’t patients get treated?
The reasons behind not getting treated or getting treated at a later date are varied and diverse. Delay in treatment seeking is not only influenced by the factors such as stigma, societal attitudes, unawareness, and underdiagnosis but also is colored by the sociocultural background of the patient.
What are two factors that decrease access to health care?
Ideally, need is the major determinant of health-care utilization, but other factors clearly have an impact. They include poverty and its correlates, geographic area of residence, race and ethnicity, sex, age, language spoken, and disability status.
Do doctors treat poor patients differently?
With some confidence, and in the light of the previous findings, we conclude that, at least within the realm of experimental approaches to the issue, doctors do not treat their patients differently based on whether they are rich or poor.
What are some challenges physicians face?
Read on for a look at some of the top challenges facing doctors today.Caring for the chronically ill. ... Managing mental illness. ... Improving communication with patients and other providers. ... Keeping up with technology. ... Using technology to engage patients.
What factors affect patient's quality of care?
External environment refers to the environment surrounding healthcare organizations that affects their performance and quality of services.Patient socio- demographic variables. ... Patient cooperation. ... Patient illness (severity of illness) ... Physician socio- demographic variables. ... Physician competence (Knowledge and skills)More items...
What current factors limit healthcare professionals ability to provide health care to the poor?
Not enough primary care physicians. Not enough medical schools. Urban blight and rural poverty limiting desirability of those neighborhoods for medical practices. No convenient and affordable transportation for poor patients to get to remote medical offices or hospitals.
What are the causes of poor health?
Health is affected by the interaction between personal and environmental factors. Environmental influences include physical, socio-economic, cultural and political factors, as well as the availability of health services.
What is the biggest challenge for physicians in the next ten years?
In a 2019 All Medical Personnel survey, U.S.-based physicians, NPs and PAs were asked what the biggest challenge to healthcare would be in the next decade. Providers overwhelmingly cited financial concerns as the biggest challenge followed by authority, staffing and availability.
What do you think are the most difficult challenges of being a doctor?
First and foremost is quite simply the inordinate amount of time to be spent working and studying. Doctors work up to 100 hours a week in some cases, depending on the particular speciality and stage of training, which might be maintained for years.
What potential risk do medical doctor face in times of work?
Risks related to stress and overwork prone to alcohol/ drug abuse/ drug exposure. Stress of balancing Family life: Kind of work and night duties effect family life very adversely.
What are three factors impacting patient outcomes?
Environmental factors that affect patient outcomes are (1) form, (2) unit layout, (3) floor material, (4) room features, (5) medical equipment visibility, (6) nature, (7) lighting, and (8) music. Although several studies have provided a high level of evidence, other studies have lacked a robust research design.
Which 4 factors contribute to quality of care?
To understand why, we have to realize that health includes more than just health care.The Social and Economic Environment.Health Behavior.Clinical Care.The Physical Environment.
What are the factors that affect health?
There are many different factors that can affect your health. These include things like housing, financial security, community safety, employment, education and the environment. These are known as the wider determinants of health.
What is the role of physicians in healthcare?
Physicians are the primary decision makers on healthcare resources . Physicians' prescribing decisions are the key for hospitals dominance over the health sector market players; pharmaceutical companies' market share; and payers target to curb costs (6,7). The variation in physician practice explains the difference in expenditure in the health sector (8,9). Patient outcome also varies with practice variations (9,10). The physician practice variation has a pronounced effect on healthcare spending increment. However, the connection between healthcare spending and outcomes is loose (4,6).The physicians' practice significantly varies in medicine prescribing and laboratory procedures ordering (11,12).
What databases were searched for factors influencing prescribing decisions of physicians from 2000 to 2016?
Electronic databases including Scopus, PubMed/MEDLINE CENTRAL, Cochrane Libraries and Google scholar were searched systematically for literatures on factors influencing prescribing decisions of physicians from 2000 to 2016. There was no restriction on the study designs.
How does the use of valid and reliable practice guidelines influence prescribing decisions?
The use of valid and reliable practice guidelines could reduce the negative impact of wide ranges of factors and promote the rational prescribing effectively.
What factors influence prescribing decisions?
The prescribing decision is the result of a multitude of intertwined factors such as the educational background of prescribers, the working environment and so on (13–15). Factors influencing prescribers' decisions are the most important input to develop practice guidelines, healthcare policy and to devise a regulation for the pharmaceutical market. In addition, the pivotal-position of physicians makes the study of factors which influence prescribing decision of tremendous worth. Therefore, highlighting factors influencing prescribing decision helps to devise a structured way to rationalize patient care process and healthcare expenditure.The aim of this review was to identify the factors affecting prescribing decision of physicians.
What is the search strategy for PubMed?
Search strategy: Electronic databases (PubMed/MEDLINE CENTRAL, Scopus, Cochrane Libraries and Google scholar) were searched from 2000 to 2016. The search was done by combining the following keywords with Boolean operators “AND” and “OR”: Prescribing, Prescription, factor, determinant, behavior, practice, preferences, inappropriate, optimal, pattern, decisions and suggest. Searching in each database was adapted to databases characteristics, and additionally Medical Subject Headings (MeSH) were considered for PubMed.
What are the factors identified from studies and reviews?
The factors identified from the studies and reviews may be grouped into several categories, namely, patient-centered factors, therapy-related factors, healthcare system factors, social and economic factors, and disease factors (Table 2).
What is the ultimate goal of a prescribed medical treatment?
The ultimate aim of any prescribed medical therapy is to achieve certain desired outcomes in the patients concerned. These desired outcomes are part and parcel of the objectives in the management of the diseases or conditions. However, despite all the best intention and efforts on the part of the healthcare professionals, those outcomes might not be achievable if the patients are non-compliant. This shortfall may also have serious and detrimental effects from the perspective of disease management. Hence, therapeutic compliance has been a topic of clinical concern since the 1970s due to the widespread nature of non-compliance with therapy. Therapeutic compliance not only includes patient compliance with medication but also with diet, exercise, or life style changes. In order to evaluate the possible impact of therapeutic non-compliance on clinical outcomes, numerous studies using various methods have been conducted in the United States (USA), United Kingdom (UK), Australia, Canada and other countries to evaluate the rate of therapeutic compliance in different diseases and different patient populations. Generally speaking, it was estimated that the compliance rate of long-term medication therapies was between 40% and 50%. The rate of compliance for short-term therapy was much higher at between 70% and 80%, while the compliance with lifestyle changes was the lowest at 20%–30% (DiMatteo 1995). Furthermore, the rates of non-compliance with different types of treatment also differ greatly. Estimates showed that almost 50% of the prescription drugs for the prevention of bronchial asthma were not taken as prescribed (Sabaté 2003). Patients’ compliance with medication therapy for hypertension was reported to vary between 50% and 70% (Sabaté 2003). In one US study, Monane et al found that antihypertensive compliance averaged 49%, and only 23% of the patients had good compliance levels of 80% or higher (Monane et al 1996). Among adolescent outpatients with cancer, the rate of compliance with medication was reported to be 41%, while among teenagers with cancer it was higher at between 41% and 53% (Tebbi et al 1986). For the management of diabetes, the rate of compliance among patients to diet varied from 25% to 65%, and for insulin administration was about 20% (Cerkoney and Hart 1980). More than 20 studies published in the past few years found that compliance with oral medication for type 2 diabetes mellitus ranged from 65% to 85% (Rubin 2005). As previously mentioned, if the patients do not follow or adhere to the treatment plan faithfully, the intended beneficial effects of even the most carefully and scientifically-based treatment plan will not be realized. The above examples illustrate the extent of the problem of therapeutic non-compliance and why it should be a concern to all healthcare providers.
What age group was included in the Medline study?
Only English-language journal articles with abstracts were included. The populations were adolescents aged 13–18 years and adults aged 19 years or older. Clinical trials were excluded since they were carried out under close monitoring and therefore the compliance rates reported would not be generalizable. Articles which were categorized by Medline in subsets on AIDS, bioethics, history of medicine, space life sciences and toxicology were not included as well.
What are the negative effects of non-compliance?
Besides undesirable impact on clinical outcomes, non-compliance would also cause an increased financial burden for society. For example, therapeutic non-compliance has been associated with excess urgent care visits, hospitalizations and higher treatment costs (Bond and Hussar 1991, Svarstad et al 2001). It has been estimated that 25% of hospital admissions in Australia, and 33%–69% of medication-related hospital admissions in the USA were due to non-compliance with treatment regimens (Sanson-Fisher et al 1992; Osterberg and Blaschke 2005). Additionally, besides direct financial impact, therapeutic non-compliance would have indirect cost implications due to the loss of productivity, without even mentioning the substantial negative effect on patient’s quality of life.
How many articles were reviewed in the literature review?
A total of 102 articles was retrieved and used in the review from the 2095 articles identified by the literature review process. From the literature review, it would appear that the definition of therapeutic compliance is adequately resolved. The preliminary evaluation revealed a number of factors that contributed to therapeutic non-compliance. These factors could be categorized to patient-centered factors, therapy-related factors, social and economic factors, healthcare system factors, and disease factors. For some of these factors, the impact on compliance was not unequivocal, but for other factors, the impact was inconsistent and contradictory.
Why focus on one disease?
Focusing intensively on one disease “will help our understanding of the role of implicit bias in clinical outcomes, ” Hagiwara says.
What words do physicians use to signal bias?
She looked at physicians’ tendency to use first-person plural pronouns such as “we,” “ours” or “us” when interacting with black patients. According to social psychology theories related to power dynamics and social dominance, people in power use such verbiage to maintain control over others of lesser power. In line with those theories, she found that physicians who scored higher in implicit bias spoke more of these words than colleagues lower in implicit bias, using language such as, “We’re going to take our medicine, right?” ( Health Communication, Vol. 32, No. 4, 2017).
Why is the IAT so bad?
Another problem is that the main measure used to assess implicit bias, the Implicit Association Test (IAT), has come under fire in recent years for reasons including poor test-retest reliability and the argument that higher IAT scores do not necessarily predict biased behavior.
How does past discrimination affect black cancer patients?
In another study, Penner and colleagues looked more specifically at how past discrimination may influence black cancer patients’ perception of care and their reactions to it . Patients who reported high rates of past discrimination and general suspicion of their health care talked more during sessions, showed fewer positive emotions and rated their physicians more negatively than those who reported less past discrimination and lower suspicion ( Social Science & Medicine, Vol. 191, 2017).
Who was the first psychologist to apply aversive racism and implicit bias in a real-world medical setting?
One of the first psychologists to apply theories of aversive racism and implicit bias in a real-world medical setting is social psychologist Louis A. Penner, PhD, senior scientist at Wayne State University’s Karmanos Cancer Institute. Along with Dovidio, Gaertner and others, he asked patients and physicians before a medical appointment about their ...
Do physicians have implicit bias?
87, 2013), Nao Hagiwara, PhD, at Virginia Commonwealth University, and colleagues found that physicians with higher implicit-bias scores commandeered a greater portion of the patient-physician talk time during appointments than did physicians with lower scores. Those findings are consistent with research by Lisa A. Cooper, MD, of Johns Hopkins University School of Medicine and colleagues, who found that physicians high in implicit bias were more likely to dominate conversations with black patients than were those lower in implicit bias, and that black patients trusted them less, had less confidence in them, and rated their quality of care as poorer ( American Journal of Public Health, Vol. 102, No. 5, 2012).
Do black patients feel the most negatively toward physicians?
The team found that black patients felt most negatively toward physicians who were low in explicit bias but high in implicit bias, demonstrating the validity of the implicit-bias theory in real-world medical interactions, says Penner ( Journal of Experimental Social Psychology, Vol. 46, No. 2, 2010).
What is poverty in family medicine?
Poverty is a complex and insidious determinant of health caused by systemic factors that can persist for generations in a family. Beginning before birth and continuing throughout an individual’s life, poverty can significantly impact health and health outcomes.
What is a family physician?
Family physicians are uniquely positioned to devise solutions to mitigate the development of risk factors that lead to disease and the conditions unique to populations with low income that interfere with effective disease prevention and management.
What is the AAFP vision?
The vision of the American Academy of Family Physicians (AAFP) is to transform health care to achieve optimal health for everyone. Primary care physicians and public health professionals continue to collaborate on a shared vision of improving population health. As the integration of primary care and public healthcontinues, ...
What can a family physician use information in the CHNA?
Family physicians can use information in the CHNA to access local health care leadership and join aligned forces in the communities we serve, thereby supporting the AAFP’s vision of achieving optimal health for everyone. References. 1.
Why are health behaviors important?
Health behaviors are important in that they account for differences in mortality.34 The fact that positive changes in health behaviors are possible despite the challenges of poverty points to the importance of developing and implementing interventions that promote healthy behaviors in populations with low income.
Is poverty a predictably uniform effect?
However, the effects of poverty are not predictably uniform. Longitudinal studies of health behavior describe positive (e.g., tobacco use cessation) and negative (e.g., decrease in physical activity) health behavior trends in populations with lower and higher socioeconomic status.
Is there a socioeconomic gradient in health?
However, there is a socioeconomic gradient in health improvement. In other words, populations with lower socioeconomic status lag behind populations with higher socioeconomic status in positive gains from health behavior trends.
What are the risks of physician burnout?
Newly published findings indicate that physician burnout is associated with an increased risk of patient safety incidents, poorer quality of care, and reduced patient satisfaction.
Why is reporting systems important for quality of care?
They add that reporting systems for quality of care and patient safety outcomes require better standardization across healthcare organizations , which will enable larger and more rigorous studies of the association between physician burnout and key components of patient care that will be accessible at an organization level and affect policy decisions.
How many studies were there in the meta-analysis?
The meta-analysis of 47 studies included over 40,000 physicians. Of the studies, 21 were based on residents and early career physicians (<5 years postresidency) and 26 considered experienced physicians. The majority of studies were based on hospital physicians (63.8%), 27.7% were based on primary care physicians, and 8.5% were based on mixed samples of physicians across all care settings.
Does burnout affect patient safety?
But now, newly published findings have indicated that physician burnout is associated with an increased risk of patient safety incidents, poorer quality of care, and reduced patient satisfaction. To read more on physician burnout, click here.
Is burnout associated with professionalism?
These findings were consistent among professionalism and patient satisfaction. Overall physician burnout was associated with twice the risk of portraying low professionalism. In particular, depersonalization was association with a 3-fold risk for reported low professionalism. Meanwhile, emotional exhaustion and reduced personal accomplishment were association with a 2.5-fold increased risk.