Transcript Adherence to Medications

Adherence to Medications
Susan E. Fleming, MN, RN
Michele Wolfe, MN, ARNP
Cindy Corbett, PhD, RN
Susan E. Fleming, MN, RN
Michele Wolfe, MN, ARNP
Cindy Corbett, PhD, RN
Learning Objectives
o Describe adherence & co-morbidity
o Identify WHO’s Five Dimensions to
Medication Adherence
o Describe self-management support
strategies for overcoming barriers to
medication adherence.
Patient Adherence to Medications
Adherence
o Mosby’s Medical Dictionary defines
adherence as
“the process in which a person follows
rules, guidelines, or standards, especially
as patients follow a prescription and
recommendations for a regimen of care”
Co-morbidity
Primary disease
+
One or more diseases
=
Co-morbidity
Self Management Support
o Demonstrating new skills
o Praise & Feedback
Self-Management
Chronic Care Model
Global Medication Adherence is 50%
WHO’s Five Dimensions of Adherence
1. Social & Economic
1. Social & Economic
o Community Support
1. Social & Economic
o Economic
1. Social & Economic
o Pictures
– Use pictures when
giving instructions
o Read Back
– Have the patient read
back the instructions
Prescription for Medication
1. Social & Economic
How to make an Economic Poster
from a PowerPoint Slide
o Go to PowerPoint
o Use Graphics and
Make a Poster
o Take a thumb drive
or disc to a Print
Shop and make a
poster.
1. Social & Economic
Use Pictures When Teaching
2. Health Care System
o Provider-Patient Relationship
2. Health Care System
o Using two-way communications and
asking open ended questions fosters
encouragement.
2. Health Care System
o Shared Decision Making
3. Condition Related
o Chronic conditions, such as hypertension,
that lack symptoms highly impact the level
of adherence
3. Condition Related
o People’s belief about the benefits and risks of
medications influence whether they abide by a
regimen.
4. Therapy Related
o Therapy-related factors include the
complexity of medication regimen and
unpleasant side effects.
4. Therapy Related
o Dosing several times
a day may
contribute to nonadherence.
4. Therapy Related
o Concern about medication side effects
remains a powerful barrier.
5. Patient Related
o Perception of need, medication
effectiveness, and safety.
5. Patient Related
o Follow up Appointments
5. Patient Related
o Personalized education and counseling sessions
delivered by telephone, intranet, or in person
by trained personnel.
Conclusion
QUESTIONS AND DISCUSSION?
References
o Agency for Healthcare Research and Quality. (2002). Preventing Disability
in the Elderly with Chronic Disease. Retrieved May 15, 2010, from
http://www.ahrq.gov/research/elderdis.htm.
o Chronic Care Model (2010). The Chronic Care Model. Retrieved June 15,
2010, from
http://www.improvingchroniccare.org/index.php?p=The_Chronic_Care_Mo
del&s=2
o Goldberg, E., Dekoven, M., Schabert, V., et al. (2009). Patient Medication
Adherence: The Forgotten Aspect of Biologics. Biotechnology Healthcare,
39-44.
o Murray, M., Morrow, D., Weiner, M., et al. (2004). A Conceptual
Framework to Study Medication Adherence in Older Adults. The American
Journal of Geriatric Pharmacotherapy, 2(1), 36-43
References continued.
o Ruppar, T., Conn, V., & Russell, C. (2008). Medication Adherence
Interventions for Older Adults: Literature Review. Research and Theory
for Nursing Practice: An International Journal, 22(2) 114-147.
o Sherman, B., Frazee, S., Fabios, R., et al. (2009). Impact of Workplace
Health Services on Adherence to Chronic Medications. The American
Journal of Managed Care, 15(7), 53-59.
o Simpson, R. (2006). Challenges for Improving Medication Adherence. The
Journal of the American Medical Association, 296(21), 2614-2616.
o World Health Organization. Adherence to Therapies: Evidence for Action.
Geneva: World Health Organization, 2003
Contact Information
Susan Fleming, MN, RN, PhD student
[email protected]
Michele Wolfe, MN, RN
[email protected]