Public Health: Non-Adherence Of Patients

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Public Health: Non-Adherence Of Patients

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Public Health: Non-Adherence Of Patients

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Question:
Discuss about the case study Public Health for Non-Adherence of Patients.

Answer:
Introduction:

The key problem the organization needs to deal with is the non-adherence of patients. The results of quality healthcare are dependent on the adherence of patients to the healthcare regimes which are recommended to them (Haskard-Zolnierek, 2012). Non-adherence of patients might prove to pose a threat to the well-being and health along with carrying an economic burden. The noncompliance or non-adherence arrives in various forms. The advice is often misunderstood, the execution is incorrect, forgotten or might be ignored. The most obvious among them is patients not taking their medicines which are supposed to cure them of their conditions. The assumption of physicians that the patients are being administered their medications regularly, makes them prescribe other dosages which lead to further complications as well as suboptimal health results (Kuhlmann and Annandale, 2010).
Extensive research has been carried out on patient adherence. Adherence can be measured on the basis of patient diaries, pill counts, reports by physicians and others, blood assays, electronic means, biologic markers and pharmacy records (Kuhlmann and Burau, 2009). The methods of assessment vary on the level of sophistication and subjectivity which ranges from patient diaries to tools which are technologically oriented such as Medication Event Monitoring System. This method measures adherence by employing a microchip mechanism to record the date and time a patient takes his/her pills or dispenses an eye drop. The physician receives a message every time the pill box is opened which reliably indicates the access to medication. However, it is a distinct possibility that the pill box might just be opened and the medication not actually taken according to prescription. Below are some interventions which might help in gaining patient adherence.
Simplifying regimen characteristics
Several strategies which have been used for the simplification of a regimen have now become practices that are well-standardized. Take for instance; adherence is improved when the patient has to take a single pill per day. When the frequency of a drug cannot be decreased, it should be matched with the daily activities of the patient (Maluf, 2015). It is likely that patients would remember to take a medicine when it is specified before or after meals.
Imparting knowledge
Adherence is positively related to the treatments and understanding of the conditions by the patients. According to several studies, the instructions in the prescription are not often understood by the patients and they tend to forget what they are advised by the healthcare professionals.
Modification of human behavior and beliefs
For complicated interventions, healthcare professionals should address the self-efficacy, intentions and beliefs of the patients. This is significant because just knowledge cannot make patients adhere to recommendations especially when the behavior change involved in it is complex.

Communication with patient
Communication with patient comprises of communication between patient and physician, involving the family of the patient in the conversation and sending reminders. The most critical of them all is the dialogue between physician and patient (Rothgang, 2010). Communicating with the family of the patient and the perception of the patient regarding social support are positively associated to adherence.
Above discussed are the best practices which would enable patient adherence but there are several other factors which make the implementation of these practices quite difficult.
The hindrances to the adherence could comprise of factors such as health system, providers and patients where the amount of interactions between them is not satisfactory. In order to improve the adherence, all the barriers should be identified and suitable measures must be implemented. Barriers might include poor communication between the health provider and patient, insufficient knowledge about a medicine and its use, not properly ready for the mode of treatment, long term drug intakes, scared of the side effects of drug, complicated regimes which involve several medications with differing schedules of dosage along with barriers of access and cost.
Leaving bias
Researches on adherence revealed that personality traits and demography are influencers in adherence. Adherence is related to education and sex and its effect can be alleviated by customizing the information according to the degree of understanding of the patient (Tynkkynen, Fredriksson and Lehto, 2013).
Evaluation of adherence
It should be noted that the problem of non-adherence is ignored to some extent by doctors. The problem cannot be corrected if it goes unrecognized. It is imperative that the adherence is measured as well as evaluated reliably.
In order to overcome the barriers and implement best practices, the patients should be informed about the way of addressing their conditions. In order to gain adherence, patients should be involved completely. Non adherence also occurs when patients are afraid of the effects of drugs. Therefore, they should be provided with clear and concise information about the medicines and if necessary, they should also be provided counseling for patient medication.
The fears and concerns can be reduced by informing the patients about the side effects of a particular medicine and ways to prevent the adverse effects. Often complexity in the regime of medication negatively impacts adherence. Hence, the regime needs modification so that the frequency could be reduced and combination products should be used, if applicable (Haskard-Zolnierek, 2012). This method requires the assistance of the patient, thus, highlighting their role in the management of diseases.
As a conclusion, it can be stated that non-adherence by patients is a global medical problem and occurs due to various interrelated causes. Although compliance can be increased by informing the patient about the condition but medical adherence is increased by proper support and motivation and usage of compliance aids. Being the research manager in the organization, strategies which are practically possible should be identified to improve the adherence within the restrictions of the practice which would eventually improve the therapeutic results (Kuhlmann and Annandale, 2010). It is a multidisciplinary approach and should be carried out in association with everybody related to the medical profession.

References
Haskard-Zolnierek, K. (2012). Communication about patient pain in primary care: Development of the Physician–Patient Communication about Pain scale (PCAP). Patient Education and Counseling, 86(1), pp.33-40.
Kuhlmann, E. and Annandale, E. (2010). The Palgrave handbook of gender and healthcare. Basingstoke: Palgrave Macmillan.
Kuhlmann, E. and Burau, V. (2009). Managerial regimes meet the healthcare state: introduction and outlook. Journal of Health Organization and Management, 23(3).
Maluf, S. (2015). Biolegitimacy, rights and social policies: New biopolitical regimes in mental healthcare in Brazil. Vibrant, Virtual Braz. Anthr., 12(1), pp.321-350.
Rothgang, H. (2010). The state and healthcare. Houndmills, Basingstoke, Hampshire: Palgrave Macmillan.
Tynkkynen, L., Fredriksson, S. and Lehto, J. (2013). Perspectives on Purchaser-Provider Co-Operation in the Local Welfare Regimes in Finland. International Journal of Public and Private Healthcare Management and Economics, 3(1), pp.17-32.

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