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Adherence to Medical Regimens

This article explores the concept of adherence to medical regimens, including different approaches, methods for measuring adherence, factors affecting adherence, and intervention strategies. It provides insights into the various factors that influence patient adherence and highlights effective intervention approaches.

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Adherence to Medical Regimens

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  1. Adherence to Medical Regimens October 31, 2007

  2. Defining Adherence • Categorical approach • Uses cutoff scores to classify • Formula approach • Combines multiple indicators or adherence • Then categorizes patients • Continuum approach • Focuses on “behavior,” not “patient” • Computes adherence rates for various health care behaviors

  3. Health status Drug assays Methods for Measuring Adherence

  4. Methods for Measuring Adherence • Self-report • Most frequently used • Tend to overestimate • Ratings by health care professionals • Often based on info given by patient • Potential for bias • Health status may be used as an indicator

  5. Methods for Measuring Adherence • Behavioral observations • Pill counts • Monitoring devices

  6. Factors Affecting Adherence • Child characteristics • Family system • Medical system • Disease & regiment considerations

  7. Child characteristics • Developmental status • Cognitive • Social-emotional • Physical • Emotional functioning • Biological functioning

  8. Parental involvement Parental knowledge & problem solving skills Parental support Stress & conflict Family System

  9. Doctor-patient relationship Contextual aspects of medical setting Provider communication Medical System

  10. Disease & Regimen Characteristics • Chronicity • Complexity • Immediate & future consequences of adherence

  11. Health Belief Model • Susceptibility to a particular illness • Severity or seriousness of the disease & its complications • Benefits of prescribed health care actions • Barriers to health care

  12. Transtheoretical Model • Precontemplation • Contemplation • Preparation • Action • Maintenance

  13. Transtheoretical Model • Decisional balance • Self-efficacy

  14. Problems in Intervention Research • Small sample sizes • Brief treatment durations & follow-up periods • Combined treatment strategies • Failure to match treatments to patient experience • Homogeneous samples

  15. Interventions • Educational approaches • Modeling • Supervision by health care professionals

  16. Interventions • Visual cues or reminders • Self-monitoring • Incentives

  17. Interventions • Social support • Reducing barriers & problem-solving

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