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Describe some psychological evidence about adherence.

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Introduction

A) Describe some psychological evidence about adherence Barat et al in 2001, conducted an investigation concerning patients adherence to medical requests made by their general practitioner, using 350 seventy year olds in Denmark. He measured adherence by compiling information from the individual's GP, interviewing the subjects and by checking their medicine cabinet. The information gathered from the GP and the information obtained from questioning the subjects and analysing the content of their medical cabinet was compared. Baret discovered that there was disagreement over the medicine in 22% of the cases, a disagreement regarding the doses required in 71% of the cases and a misunderstanding about the treatment programmes in 69% of the cases. Only 60% of the 350 subjects knew of the purpose of the drugs that they were taking, 21% were aware of the problems that would arise if they stopped taking the drugs prescribed to them, and only 6% knew the possible side effects of the medicines they were taking. When being questioned, 24% of the patients said that they didn't always stick to the prescription precisely, though this was commonly with low dose and less frequent use drugs. ...read more.

Middle

This assessment was done through the mother's reports and, when possible through pill counts or contacts with the pharmacy where the drugs where obtained from. It was discovered that those mothers who were very pleased with the doctor's concern and communication of information were three more times likely to adhere closely to the regimes than those who were dissatisfied. What has been found out about adherence from this piece of research is that health workers play a huge role in whether or not a patient complies to medical requests. If they show little emotion and do not seem encouraging then this is likely to decrease the trust the patient has in the doctor and thus decrease adherence rates. One other factor, which affects a patient's adherence, is whether or not the health worker presents the information in a way that he or she will be able to recall the info at a later stage when needed. If a patient cannot recall how to follow their medical treatment, how can they adhere to it? Ley et al, in 1973, investigated how accurately people can remember medical statements. A list of medical statements was given to patients attending a clinic and were asked to recall the list. ...read more.

Conclusion

Let et al's study regarding the way in which medical advice affects adherence has potentially very useful information concerning how information should be presented to a patient in order to improve their compliance. However, the study lacks ecological validity, since it does not measure true to life behaviour. How often does one get asked to recall a list of medical statements when visiting their general practitioner? The study is about list learning, not about the actual consultation. The patients may not have paid much attention to the test as they would to the consultation with their doctor. They are more likely to pay attention to what the doctor tells them and try to remember it all. Therefore, can this study really be applied to practical situations? C) Based on the above evidence, suggest one-way health workers can improve adherence. One way in which health workers can improve a patient's adherence is to present the information given by the health worker in a structured and organised way so that the patient is able to recall the advice later on when it is needed. If the patient cannot recall the information then they will not be able to adhere to the treatment. ...read more.

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