Transcript Drug Compliance in Patients with Hypertensive Disease

Timothy E. Gibbs, BA, NPMc
Executive Director, Delaware Academy of Medicine
Objectives
At completion of this presentation the audience will
understand:
1. The importance of drug regime compliance
2. How adherence and compliance are similar, yet
different
3. Identifying barriers to, and negotiating adherence
with patients needing medication.
4. How non-compliance is similar to drug “abuse”
An estimated 50% of all patients
do not take medications properly:
•Right dose,
•Right time,
•Right conditions
When patients are asymptomatic . . .
Non-compliance
rates increase
dramatically to an
estimated 75%
percent.
Providers tend to OVERESTIMATE
medication compliance
Compliance and Adherence
Similar meanings, but
different connotation:
“Comply” means
something like “Do
what I tell you”
“Adhere” means
something like “Stick to
the plan”
The word “Compliance” defines
•A power dynamic
between provider and
patient
•Patient has less
control
•Patient has greater
opportunity to “fail”
When patients fail to COMPLY—
Blame is
placed on the
patient rather
than the
provider.
Barriers to Adherence
•Economic
•Social
•Behavioral
•Environmental
•Cultural
•Biological
Barriers to Compliance:
Confusing and
conflicting drug
regimes may be
a substantial
barrier.
Recognizing Another Barrier
Healthcare
Provider-Patient
Relationship
Must be based on
mutual respect and
trust . . .
Adherence is Improved if a Patient:
• Takes part in negotiating
the treatment plan
• Understands the disease
and treatments
• “Buys into” or believes in
the treatment plan
When patients believe in the
Treatment Plan
•They adhere to the
medication regime AND
•They seek out support for
lifestyle changes, like
•DIET
•EXERCISE
Providers Need to
LISTEN to and
ADDRESS patients’:
•Fears
•Lifestyle concerns
•Social and family
issues
TEACH patients about:
•Disease process
•Medication side
effects
Opportunities to reduce barriers
•Health education
•provider/patient relationship and
negotiating
•Better protocols with fewer side
effects
•Cues to non-adherence
How does Medication Non-Adherence
compare to Drug Abuse?
•Failing to take medications
as prescribed
• Taking medications NOT
prescribed
•Not seen as an ethical
breach
•Seen as an ethical breach
•Poor health outcomes
•Poor health outcomes
•Financial costs to families
and society
•Financial costs to family
and society
Non-Adherence
Drug Abuse
Legal Concerns
If it’s illegal to consume an
illicit drug, should it also be
illegal to FAIL to take a
prescribed drug?
What about
Immunizations?
TB programs?
Forced quarantine?
Further Research is Needed
To bridge the
gap between
what it means
to take a drug
to feel good,
versus taking a
drug to be well.
Conclusion/Questions