What is treatment adherence and why is it important?
Treatment adherence (also called medication adherence) includes starting HIV treatment, keeping all medical appointments, and taking HIV medications every day and exactly as prescribed. For individuals with HIV, treatment adherence is key to staying healthy. Learn about adherence with the following resources.
What is HIV treatment adherence?
Treatment adherence (also called medication adherence) includes starting HIV treatment, keeping all medical appointments, and taking HIV medications every day and exactly as prescribed. For individuals with HIV, treatment adherence is key to staying healthy.
Is medication adherence the same as medication compliance?
Medication is, after all, a form of treatment. Dr. Kraig Shell, in an article for Pharmacy Times, notes that literature often confuses medication adherence vs medication compliance, as it also does for treatment adherence vs compliance.
Is low adherence to medication treatment a silent epidemic?
A World Health Organisation (WHO) report underlines the fact that adherence to chronic treatments is as low as 50% [1]. More recent data describe low-adherence as being a “silent epidemic”, which is likely to play a role in 21–37% of preventable adverse drug events [2].
What increases adherence?
Successful strategies to improve medication adherence include 1) ensuring access to providers across the continuum of care and implementing team-based care; 2) educating and empowering patients to understand the treatment regimen and its benefits; 3) reducing barriers to obtaining medication, including cost reduction ...
How can treatment adherence be increased?
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 measure adherence to treatment?
Medication adherence can be measured by several methods, including (a) self-report questionnaires or structured interviews, (b) therapeutic drug monitoring (TDM), (c) electronic devices, and (d) pick-up/refill rates.
What is the best predictor of adherence to a care plan?
In meta-analytic work, findings suggest that one of the strongest predictors of patient nonadherence to medical treatment is patient depression (DiMatteo et al 2000).
What can the nurse do to maximize a patient's adherence to the medication regimen?
The following are ten strategies that providers can use to boost medication compliance.Understand each patient's medication-taking behaviors. ... Talk about side effects. ... Write it down. ... Collaborate with patients. ... Consider the financial burden to the patient. ... Assess health literacy. ... Reduce complexity. ... Follow up with patients.More items...•
Which one of the following might be the best way to measure adherence to a prescribed medication regime?
Pill counts i.e. counting the number of pills that remain in the patient's medication bottles or vials is a common method to measure adherence.
What is the gold standard for measuring adherence?
Adherence is commonly assessed using pill counts, self-report or electronic monitoring, with the latter widely considered the 'gold standard'. We assessed the concordance of these three methods in a sample of 52 elderly patients with heart failure over a six-week period.
What is objective measure of adherence?
While pharmacological adherence measures provide objective information on whether the medication was ingested, behavioral adherence measures such as electronic monitoring provide daily information regarding the date/time medication was removed from the bottle, thus directly complementing one another.
What is health care adherence?
In medicine, patient compliance (also adherence, capacitance) describes the degree to which a patient correctly follows medical advice.
What factors affect patient compliance?
This list of potential barriers included:Demographic factors such as age, ethnicity, gender, education, marriage status.Psychosocial factors: beliefs, motivation, attitude.Patient-prescriber relationship.Health literacy.Patient knowledge.Physical difficulties.Tobacco or alcohol intake.Forgetfulness.More items...•
Which of these personal characteristics is generally the most accurate predictor of patient adherence?
The following disease characteristic is the MOST accurate predictor of patient adherence: severity of the disease as seen by the attending physician.
Who adherence factors?
Among the five dimensions of adherence, we found socioeconomic, health system-related, therapy-related, and patient-related dimensions to be significantly affecting adherence, while clinical condition dimension was found to play less of a role.
What is treatment adherence?
The current definition of treatment adherence, as given by the WHO, is “the extent to which a person’s behavior- taking medication, following a diet, and/or executing lifestyle changes- corresponds with the agreed recommendations from a healthcare provider” [1].
Why is adherence to treatment important?
Optimal treatment adherence is essential for the management of chronic conditions and the effectiveness of prescribed therapies. A World Health Organisation (WHO) report underlines the fact that adherence to chronic treatments is as low as 50% [1].
What is the effect of low adherence in chronic conditions?
A low rate of adherence in chronic conditions is associated with poor outcome and decreased quality of life , which constitutes an additional burden for the healthcare systems.
What is the definition of persistence?
Persistence is expressed as a continuous variable, reporting the number of days for which treatment was available.
Is the adherence method supplementary data?
The method is appropriate for the measurement of adherence to one drug therapy regimen only and it offers no supplementary data on the additional causes of non-adherence and does not report on any patterns of non-adherence. It is also quite expensive, and could be viewed as interventional by some patients.
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].
Asthma Treatment Adherence
For this project, we study the patterns of use of controller medications for children with high risk, urban asthma in order to implement timely interventions that target the causes of lapsed patterns of controller medication use.
Treatment Adherence Published Research
Kenyon CC, Chang J, Wynter SA, Fowler JC, Long J, Bryant-Stephens T. Patterns of Inhaled Corticosteroid Adherence in a High-Risk Urban Asthma Medicaid Cohort. Abstract poster presentation at Pediatric Academic Societies, San Diego, CA. April, 2015.
Why do patients try to alter how they approach treatment?
For example, if patients are unhappy with a treatment's effects — whether due to limited signs of improvement, slower improvement than desired, or unexpected side effects — they may try to alter how they approach treatment. This can also occur when patients experience improvements.
What are the services that patients are expected to continue treatment?
These can include specialists, imaging, rehabilitation, and laboratories. If traveling to new providers and organizations proves difficult, patients may elect not to do so.
What is compliance in medical terms?
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.
How much does nonadherence cost?
1 In the US, nonadherence is responsible for an estimated 125,000 deaths and between $100 to $300 billion in medical costs annually. 2.
What is nonadherence in medical terms?
The definition of adherence also varies: nonadherence is defined as patients missing medications from 20% to 50% of the time. 4. Adherence is almost always overestimated.
Why is MPR more accurate?
Because the assumption is that nonadherent patients are unlikely to fill their prescriptions, MPR is likely to overestimate adherence for patients who fill their prescriptions. The Proportion of Days Covered (PDC) can be more accurate. It uses several “covered” days for which patients have medications on hand.
What is the measure of medication possession?
Most commonly used measures are Medication Possession Ratio (MPR) and the Proportion of Days Covered (PDC). MPR is the ratio of the number of days for which a patient has medications on hand divided by the total number of days the patient was observed.
What is the most frequent intervention in psychiatric disorders?
The most frequent intervention was patient education and counseling, with positive results seen in half the studies. Interventions delivered by nurses and pharmacists had better results than those provided by physicians. 10. There are no studies that are specific to nonadherence in patients with psychiatric disorders.
Is multilevel intervention more effective?
Studies have generally shown that improved engagement with patients results in greater adherence. Overall, multilevel interventions are likely to be more effective ( Table 2 ).
Is privacy assured in mental health apps?
The apps can be a useful and easy way to get information and measure certain behaviors; however, privacy is not assured, and they can be inaccurate. In a review of 571 mental health apps, 60% did not use validated screening tools and two-third of the apps did not provide a privacy policy.
