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ADHERENCE TO MEDICAL ADVICE The Health Organisation 1996 says that: 'Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity'. Adherence to medical advice includes why people don't adhere to medical advice, measuring adherence and improving adherence. Barat et al.(2001) conducted semi-structured interviews in which they aimed to find the variables that affect adherence to health requests made by General Practitioners (GP). The information gathered was collected from 350 70 year olds who were visited by experimenters, who looked in their medicine cupboard and asked them questions about the frequency of taking the medicine and about the medicine itself. The GP's of the patients were also asked about their patient's prescription, which was compared to the answers given by the participants. It was found that there was disagreement by 22% over the medicine, 71% over the doses, 69% over the treatment programme used. 24% of the participants did not always follow up their prescription, but this was common amongst those who had a low dose or was less frequently taken. Only 60% knew the purpose of their medicine, 21% knew the problems that would arise if they stopped taking their medicine and only 6% knew the possible side effects of the drugs. ...read more.


Kulik and Carlino were able to study the behaviour/adherence of the children in their own environments. By conducting a field experiment there is a reduction in demand characteristics. There is however little control over the variables and by asking the children to give urine samples, there is the possibility of it being stressful for them. Another evaluation issue to be discussed is ecological validity. Ecological Validity refers to how well a study can be related to everyday life. By conducting a quasi experiment, Sherman et al had increased ecological validity- more so than the laboratory experiments. This study is high in ecological validity due to the experimental method used. There was no need for experimentation/pretence. There are no forced situations. Phone calls were made, then calculations, and many records were investigated. It is true to everyday life in the sense that it is nothing out of the ordinary that the patients are doing or that the experimenters needed to do. Another study that was relatively high in ecological validity was that of Kulik and Carlino. It was true to everyday life in that patients attending a surgery as normal, however to have to give urine samples to monitor adherence, it is not very true to everyday life. ...read more.


Getting children to take medication with the aid of their parents is difficult enough, but making them take their medicine without persuasion or help is even harder. One such medication is an asthma inhaler. Psychologists have found out that patients tend to adhere to medical advice when there is an incentive which has been pointed out to them. The study by Barat et al. shows that patients are much more likely to adhere to a treatment if they know more about the treatment. To make the child's adherence to the medical subscription better then a reward scheme (positive reinforcement) could be introduced, for example for every week/month the child has a perfect dosage score then they will receive a bag of sweets. The doses could be measured using an electronically device similar to the 'TrackCap' used by Chung and Naya (2000) in heir experiment. Each time the child goes to the doctor the child gives him his inhaler and the doctor checks to see if the number of uses and refills fit's the time period, if so the child would get a reward. With the incentive of the sweets the child would become more eager to get a perfect score and get his sweets, the positive reinforcement therefore causing the child to adhere to the prescription far better. ...read more.

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