And cancer gastrointestinal adherence very low with

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Unformatted text preview: patient took the Not pills or the correct number of pills. pills Recovery – if they recovered, they must have Recovery adhered to medication instructions. adhered Not necessarily true Other variables may mediate relationships between Other medication adherence and recovery. medication Causes of Adherence Good communication Understanding/Comprehension Satisfaction with Communication (warm, caring) Jargon free explanation of etiology, diagnosis, and Jargon treatment recommendations. treatment Ask patient to repeat recommendations and Ask physician can clarify any misunderstandings. misunderstandings. Encourage patient to ask questions and Encourage answer patient questions. answer Provide recommendations in written form. Try to get patient to commit to adherence Try (“So, do you think you can do this?”) (“So, Qualities of the Treatment Regimen can Qualities influence degree of adherence. influence Low adherence for treatments that are: Long term Complex (e.g. taking blood sugar readings) Interfere with desired activities Advice more likely to be adhered to if it is Advice perceived as “medical” (take medications) than as vocational (rest, take time off from work) and even lower if perceived if social/psychological (avoid stressful social situations). situations). Nonadherent patients cite: Lack of time Lack of money Distracting problems at home as barriers to adherence. Adherence is higher among patients with Adherence cohesive families and lower among those with families in conflict. families Depressed people are less adherent. Some patients engage in creative Some nonadherence. nonadherence. Lower income patients - lower dosage to make Lower medicine last longer. medicine Keep some medication to give to sick family Keep member. member. If patient does not understand dosage, they If may not take any for fear of overmedicating. may May stop medication because of unpleasant May side effects. side Nonadherence may come from patient’s Nonadherence private theories or schemas about the disorder schemas and treatment. and Example: May use OTC drugs to supplement Example: doctor’s prescribed meds, which could interact in negative ways. in Example: If 2 pills a day for 10 days will cure Example: the problem, then 4 pills a day for 5 days will cure twice as fast. cure So often nonadherence is intentional as well as So accidental. accidental. Another by-product of poor patient-provider Another communication has been a very large increase in malpractice lawsuits. malpractice Malpractice lawsuits also tied to complexity of Malpractice the healthcare system – may not sue the physician but will sue the institution/hospital since they convince them the money will not be missed. be Research suggests that lawsuits were initiated Research against physicians who were: against Fearful of patients Insecure with patients Derogatory toward patients, ignored, rudely Derogatory dismissed patients dismissed Patients want: Want a clear (not evasive) apology from do...
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