Which is most often a result of poor adherence to diabetic regimens?
Which of the following best predicts compliance with a diabetic treatment regimen? include cigarette smoking. ... During the initial treatment for myocardial infarction, a patient who copes by using denial is likely to have ... Poor adherence to diabetic regimens by people with Type II diabetes is most often a result of.
How can we promote compliance among patients with diabetes and epilepsy?
Apr 01, 2006 · Research has generally shown that lower regimen adherence can be expected when a health condition is chronic, when the course of symptoms varies or when symptoms are not apparent, when a regimen is more complex, and when a treatment regimen requires lifestyle changes. 1 Studies with diabetic patients indicate better adherence to medications than to …
Is medication adherence related to glycemic control in type 2 diabetes?
Jul 22, 2016 · Several recent reviews have confirmed these findings, with adherence rates for patients with chronic diseases, including T2D, found to be significantly lower for any medication regimen requiring more than once-daily dosing (79%–94% once daily vs 38%–67% three times daily; P<0.05). 43, 44 Beyond the influence of dosing schedules, recent data ...
Why do type 2 diabetics fail to achieve adequate glycemic control?
Poor adherence to diabetic regimens by people with Type II diabetes is most often a result of: ... During the initial treatment for myocardial infarction, a patient who copes by using denial is likely to have: ... Which of the following best predicts compliance with a diabetic treatment regimen?
Which of the following factors has been found to be related to increased risk of coronary heart disease quizlet?
The traditional risk factors for coronary artery disease are high LDL cholesterol, low HDL cholesterol, high blood pressure, family history, diabetes, smoking, being post-menopausal for women and being older than 45 for men, according to Fisher. Obesity may also be a risk factor.Jul 31, 2015
Which of the following factors has been found to be related to increased risk of coronary heart disease CHD )?
The major risk factors. There are many risk factors for CAD and some can be controlled but not others. The risk factors that can be controlled (modifiable) are: High BP; high blood cholesterol levels; smoking; diabetes; overweight or obesity; lack of physical activity; unhealthy diet and stress.
Which condition leads to one out of every six deaths in the United States each year and is also related to stress?
Chronic stress is linked to six leading causes of death including heart disease, cancer, lung ailments, accidents, cirrhosis of the liver and suicide, according to the American Psychological Association.
Which of the following is a risk factor for heart disease?
Several health conditions, your lifestyle, and your age and family history can increase your risk for heart disease. These are called risk factors. About half of all Americans (47%) have at least 1 of 3 key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.Dec 9, 2019
What causes atheroma?
They develop when cholesterol sticks to the wall of the artery. Your immune system, sensing a problem, will send white blood cells to attack the cholesterol. This sets off a chain of reactions that leads to inflammation. In a worst-case scenario, cells form a plaque over the cholesterol, and a small blockage is formed.
How do you confirm myocardial infarction?
Additional testsChest X-ray. An X-ray image of your chest allows your doctor to check the size of your heart and its blood vessels and to look for fluid in your lungs.Echocardiogram. Sound waves (ultrasound) create images of the moving heart. ... Coronary catheterization (angiogram). ... Cardiac CT or MRI.
What is the most common cause of sudden death?
What causes sudden cardiac death? Most sudden cardiac deaths are caused by abnormal heart rhythms called arrhythmias. The most common life-threatening arrhythmia is ventricular fibrillation, which is an erratic, disorganized firing of impulses from the ventricles (the heart's lower chambers).May 14, 2019
What causes sudden death in elderly?
Abstract. Sudden cardiac death (SCD) is a major cause of mortality in elderly individuals owing to a high prevalence of coronary heart disease, systolic dysfunction, and congestive heart failure (CHF).
Is diabetes a risk factor for coronary artery disease?
Diabetes mellitus is associated with an increased risk of cardiovascular death and a higher incidence of cardiovascular diseases including coronary artery disease.Sep 8, 2012
Which treatments would most likely be recommended for type 2 diabetes?
Metformin (Fortamet, Glumetza, others) is generally the first medication prescribed for type 2 diabetes. It works primarily by lowering glucose production in the liver and improving your body's sensitivity to insulin so that your body uses insulin more effectively.Jan 20, 2021
Which of the following are risk factors for heart disease check all that apply?
Major risk factors for heart disease that can be controlled or changedSmoking. Smoker's are at twice the risk of heart attack than are non-smokers. ... High blood pressure. ... High blood cholesterol. ... High blood sugar (diabetes). ... Obesity and overweight. ... Physical inactivity. ... Stress may be a contributing factor to heart disease.
What are the 7 major risk factors for coronary heart disease?
Risk factors for coronary artery disease include:Age. Getting older increases your risk of damaged and narrowed arteries.Sex. Men are generally at greater risk of coronary artery disease. ... Family history. ... Smoking. ... High blood pressure. ... High blood cholesterol levels. ... Diabetes. ... Overweight or obesity.More items...•Jun 5, 2020
What is Susan's cancer?
Susan has breast cancer. She is anxious and depressed. Although she receives a lot of help from her family and friends, she is unable to manage her treatment regime. She is scared of losing the organ and is worried about the reoccurrence of the cancer and pain. She is also worried that her cancer might be fatal.
What are the factors that contribute to midlife crisis?
One of the important contributing factors to midlife crisis is the: gradual realization of impending death. When young children experience the impending death of a sibling, the best approach is: to inform them in advance about the impending death.
Which country has the only health care system financed by for-profit, minimally regulated, private insurance companies?
African Americans. is the only country where health care for most people is financed by for-profit, minimally regulated, private insurance companies. United States. Sara, a health psychologist, uses technology effectively to implement behavioral interventions.
Can long term care affect the immune system?
Long-term provision of care to friends or family members with long-term illness has been linked to adverse effects on almost all functional measures of the immune system. This can be attributed to caregivers': experience of severe stressors. may mute the adverse effects of stress on the immune system.
What is Raj's diagnosis?
The diagnosis reveals that his blood vessels have narrowed and the flow of oxygen and nourishment to his heart is partially obstructed. He is most likely suffering from. coronary heart disease.
Does social support cause marital strain?
During cardiac rehabilitation of a patient, social support is . likely to cause marital strain when it is provided by the spouse. In a study of cardiac invalidism (Taylor et al., 1985), wives' perceptions of their husbands' cardiac and physical efficiency were highest when they had.
Scope of the Problem
It has been generally acknowledged for years that nonadherence rates for chronic illness regimens and for lifestyle changes are ∼50%. 1 As a group,patients with diabetes are especially prone to substantial regimen adherence problems.
Factors Related to Adherence
To improve patient adherence, it is important to understand why nonadherence occurs. A substantial literature has documented a number of factors related to diabetes regimen adherence problems.
Compliance and Adherence
Most health care providers use the term “compliance” instead of“adherence,” although these concepts are quite different. Compliance has been defined as “the extent to which a person's behavior coincides with medical advice.” 1 Noncompliance then essentially means that patients disobey the advice of their health care providers.
Collaborative Care Model for Chronic Illness
In the care of acute health conditions, provider-directed,compliance-oriented care may be very helpful. However, for treatment of chronic illnesses such as diabetes, there are clear limitations to compliance-or adherence-oriented approaches.
Improving Patient Self-Care Behaviors
Ironically, to improve diabetic patients' compliance or adherence, health care professionals should first abandon the concept of trying to get their patients to comply or adhere better.
Summary
Compliance or adherence problems are common in diabetes management. Many factors are potentially related to these problems, including demographic,psychological, social, health care provider and medical system, and disease-and treatment-related factors.
What are the factors that contribute to poor adherence to diabetes medications?
Poor medication adherence in T2D is well documented to be very common and is associated with inadequate glycemic control; increased morbidity and mortality; and increased costs of outpatient care, emergency room visits, hospitalization, and managing complications of diabetes. Poor medication adherence is linked to key nonpatient factors (eg, lack of integrated care in many health care systems and clinical inertia among health care professionals), patient demographic factors (eg, young age, low education level, and low income level), critical patient beliefs about their medications (eg, perceived treatment inefficacy), and perceived patient burden regarding obtaining and taking their medications (eg, treatment complexity, out-of-pocket costs, and hypoglycemia). Specific barriers to medication adherence in T2D, especially those that are potentially modifiable, need to be more clearly identified; strategies that target poor adherence should focus on reducing medication burden and addressing negative medication beliefs of patients. Solutions to these problems would require behavioral innovations as well as new methods and modes of drug delivery.
What does TZD stand for?
Abbreviation:TZD, thiazolidinedione. Another commonly used metric is medication persistence. Unfortunately, definitions vary even more widely here. Persistence is often defined as no gap in prescription drug supply for at least 30 days, although in some studies the definition is extended to ≥60–90 days.
What is poor adherence?
Poor adherence is associated with inadequate glycemic control, increased use of health care resources, higher medical costs, and markedly higher mortality rates. 16, 27, 28 Among >11,000 veterans with T2D who were followed up for at least 5 years, poor medication adherence (MPR <80%) was significantly ( P <0.001) associated with poor glycemic control (HbA1c >8%). 16 The National Health and Wellness Survey of 1,198 patients with T2D found that each 1-point drop in self-reported medication adherence (using the Morisky Medication Adherence Scale) was associated with 0.21% increase in HbA1c, as well as 4.6%, 20.4%, and 20.9% increase in physician, emergency room (ER), and hospital visits, respectively. 28
What are the factors that contribute to T2D?
One of the major contributing factors is poor medication adherence. Poor medication adherence in T2D is well documented to be very common and is associated with inadequate glycemic control; increased morbidity and mortality; and increased costs of outpatient care, emergency room visits, hospitalization, and managing complications of diabetes.
How many people will have T2D by 2035?
3, 4 Indeed, the worldwide prevalence of T2D is expected to increase from 382 million individuals (2013) to 417 million individuals by 2035. 1 This is of critical concern because T2D represents the largest budget item in many health care systems, 5, 6 primarily due to the high rates of morbidity and mortality associated with the disease. 7 – 9 Even worse, it has been well documented that this cost burden has been inexorably growing worldwide. 10
What is the number one killer in the United States?
The number-one killer in the United States, accounting for one out of every four deaths, is: coronary heart disease.
Do migrants have a high incidence of CHD?
Migrants have a high incidence of CHD. According to the research by Gallacher et al., (1999) and Boyle et al., (2004), which of the following emotions increases the risk of heart disease, predicts poor likelihood of survival, and acts as a potential trigger for heart attacks. anger.
Is Raj a risk factor for CHD?
It is an independent risk factor for CHD. Raj, who complains of chest pain, is admitted to a hospital. The diagnosis reveals that his blood vessels have narrowed and the flow of oxygen and nourishment to his heart is partially obstructed. He is most likely suffering from:
Does Prozac help with depression?
patients and their spouses underestimate a patient's physical abilities. Depression is typically treated with Prozac, which is a (n): serotonin reuptake inhibitor. Poor adherence to diabetic regimens by people with Type II diabetes is most often a result of: their unawareness of the health risks.
How Do We Recognize the Need for Intervention?
The breadth of the gap between providers’ recommendations and those behaviors patients choose to adopt, observed in either research or clinical practice, depends in large part on how it is assessed; estimates range widely as a result.
What Approaches to Improving Adherence Seem to Work?
In reviewing approaches to adherence, it is helpful to consider separately the aspects of adherence being improved and the type of intervention being considered. Haynes 2 and Roter et al. 4 classify interventions into three similar categories (although they use slightly different labels for them): educational, behavioral, and affective.
Summary and Conclusions
Our glass is half full. A wide variety of methods to improve all aspects of patient adherence to treatment recommendations for diabetes have been studied. Even though many interventions used have been applied broadly to populations without tailoring to individual patients’ stage of change, 35 a modicum of success is often attained.
Article Information
The authors are grateful to Donna Tomlinson, MD, MSc, for helpful discussions and advice. Preparation of this manuscript was supported in part by National Institutes of Health Grants DK 20541 and EY 13497.
What is treatment compliance?
Treatment compliance is defined as the degree to which patients’ behaviors (e.g., attending follow-up appointments, engaging in preventive care, following recommended medical regimens) correspond with the professional medical advice prescribed. The terms compliance and adherence are often used interchangeably; however, because compliance may carry a negative connotation, some prefer to use adherence to emphasize patients’ active roles in healthcare management as opposed to the submissiveness suggested in the definition of compliance. This distinction in definition acknowledges that patients and providers can move away from the patriarchal model of health care, promotes patient autonomy, and takes into account evidence suggesting that those who adhere steadfastly to providers’ instructions may not be the healthiest psychologically or physically. While the patient’s active role is considered vital in committing to a treatment regimen, for the purposes of this overview, the term compliance is utilized to maintain consistency.
What are objective measures of compliance?
Pill counts, electronic bottles, and urine or blood serum levels are examples of objective measures of compliance. Although these measures can be expensive, many lessen opportunities for recall bias and human error via electronic tracking (e.g., counting number of puffs pressed on an inhaler). While they cannot guarantee that the patient completed the treatment, increased accuracy has been reported when using objective measures of compliance. Parents also report feeling more comfortable allowing their children to take control of treatment protocols when such devices are utilized.
How does treatment compliance affect adolescents?
For children and adolescents, treatment compliance is influenced by numerous factors. In general, females are more compliant than males, and adolescents are less compliant than younger children. Among adolescents, researchers report that compliance may be related to adolescents’ needs for independence combined with their willingness (or lack thereof) to accept the authority of healthcare providers. For example, research suggests that a cancer diagnosis coupled with cognitive impairments resulting from aggressive treatments predicts poorer decision-making abilities, including higher incidences of high-risk behaviors (e.g., smoking, drug use). Self-esteem, cognitive and social functioning, lower socioeconomic status, lower parent education, feelings of invincibility, illness knowledge, perceived vulnerability, treatment complexity, emotional problems, and prevailing psychiatric illness also relate to compliance.
Why is compliance with asthma so problematic?
For example, among children with asthma, compliance is often problematic, because the disease can be unpredictable with long symptom-free periods.
How does compliance increase?
Compliance increases when patients believe treatments are necessary and important. Healthcare providers play a critical role in this process by helping patients weigh the risks and benefits while taking into consideration social contexts and perceived barriers. Successful compliance also requires that an individual develops the motivation and self-efficacy required to confront a long-term stressor.
Why are self-reports used?
Self-reports are commonly used to assess compliance . Examples include Likert scale questionnaires, handheld computers, and phone diaries. Although self-report measures are the simplest measures to use, report bias and recall precision issues often make results inaccurate. These inaccuracies can result in over-reporting, because patients may answer questionnaires consistently with what they believe promotes support and approval from providers. Underreporting is also concerning, with some research suggesting higher compliance when using objective measures as compared to self-reports. Despite challenges involved and acknowledgment that self-reports should be interpreted cautiously, because of their practicality, research supports using self-reports in clinical settings.
What are some examples of behavioral compliance?
Examples include the health belief model by Marshall Becker and colleagues, which states that compliance is related to beliefs about illness severity and treatment regimen benefits as well as vulnerability perceptions. Irwin Rosenstock and colleagues’ health benefits model add that patients will weigh the treatment costs and benefits before deciding whether to perform the recommended behaviors. Individuals who view themselves as more vulnerable or who view their illness as very serious are likely to exhibit greater compliance with health behaviors, thereby promoting positive outcomes. The role of self-efficacy, included in models such as Howard Leventhal’s self-regulatory model of illness and Ronald Roger’s protection motivation theory, is also salient in that patients displaying higher levels of confidence in their ability to complete treatment are more likely to succeed.