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Timothy E. Gibbs, BA, NPMc Executive Director, Delaware Academy of Medicine. Drug Compliance and adherence: A Public Health Perspective. Objectives. At completion of this presentation the audience will understand: The importance of drug regime compliance - PowerPoint PPT Presentation
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Timothy E. Gibbs, BA, NPMcExecutive Director, Delaware Academy of
Medicine
Objectives
At completion of this presentation the audience will understand:
1.The importance of drug regime compliance2.How adherence and compliance are similar, yet different3.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 AdherenceSimilar 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 RelationshipMust 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?
Non-Adherence Drug Abuse
•Failing to take medications as prescribed
•Not seen as an ethical breach
•Poor health outcomes
•Financial costs to families and society
• Taking medications NOT prescribed
•Seen as an ethical breach
•Poor health outcomes
•Financial costs to family and society
Legal ConcernsIf 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 NeededTo bridge the gap between what it means to take a drug to feel good, versus taking a drug to be well.
Conclusion/Questions