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level: Level 1 of Patient Medication Adherence.pptx

Questions and Answers List

level questions: Level 1 of Patient Medication Adherence.pptx

Question	Answer
The extent to a persons behavior taking medication corresponds with AGREED RECOMMENDATIONS from a health care provider Emphasizes the ACTIVE PARTNERSHIP between the healthcare professional and the patients. seeks the patient’s consent to the proposed treatment	Adherence
is the ONE OF THE MOST IMPORTANT FACTORS that determines the therapeutic out comes, especially in a patient suffering from chronic illness/diseases.	Medication adherence
“The degree to which the patient follows the treatment instructions given by the healthcare provider” Without active collaboration in decision-making of the treatment process	COMPLIANCE
1 The term __ has come into disfavor because it suggests that a person is PASSIVELY following a doctor's orders, rather than actively collaborating in the treatment process. 2 __, on the other hand, requires the person's agreement to the recommendations for therapy.	1 COMPLIANCE 2 Adherence
defined as the ABILITY of a person to CONTINUE TAKING MEDICATIONS for the intended course of therapy. In the case of chronic diseases, the appropriate course of therapy may be months, years, or even the person's lifetime. Discussing the intended course of therapy when medications are first started has been shown to be an important factor in keeping people's __ with a medication regimen.	PERSISTENCE
A person is classified as __ if he or she never fills a prescription or stops taking a prescription prematurely.	non-persistent
Medication Non-adherence percentages 1 Pain medications never filled 2 enter nursing homes because they can't self medicate on their own 3 Prescriptions for Chronic Conditions 4 Missed or Overdoses of medication (Hospital admissions for seniors)	. 1) 65% 2) 40% 3) 31% 4) 30%
Types of Non-adherence	1 Non-fulfillment 2 Non-persistence 3 Non-conforming
Non-fulfillment give examples	1 Prescription is never filled
Non-persistence give examples	- Px stopped taking the medication after taking it rarely intentional (due to miscommunication, reduced capacity, etc)
Non-conforming give examples	1 Medication is not taken as prescribed 2 Missed doses, Incorrect doses, Dose taken at the wrong time
“poor medication taking behavior due to circumstances BEYOND THE PATIENT’S CONTROL, such as socioeconomic issues, carelessness, forgetfulness and cognitive impairment”	Unintentional Nonadherence
Related to patient’s OWN BELIEFS and APPRAISALS of the medication Occurs when the patient makes a conscious decision NOT TO FOLLOW THE MEDICATION REGIMEN AS RECOMMENDED. Occurs when the PATIENT OPT NOT TO TAKE THE MEDICINES An active process where the PATIENT DECIDES NOT TO USE TREATMENT or follow treatment recommendations	Intentional Medication Nonadherence
Adherence is a multidimensional phenomenon determined by the interplay of FIVE SETS OF FACTORS, termed "DIMENSIONS" by the World Health Organization: In simple terms: GIVE FIVE SET OF FACTORS OF ADHERENCE	1. Social/economic factors 2. Provider-patient/health care system factors 3. Condition-related factors 4. Therapy-related factors 5. Patient-related factors SP CTP
THERE ARE SEVERAL WAYS TO MEASURE MEDICATION ADHERENCE.	1. Medication Event Monitoring Systems (MEMS) - the most accurate 2. Patient self-reports - easiest method 3 Pill Counts 4 Pharmacy databases or Refill rates 5 Blood levels 6 Morisky's Medication Adherence Scale (MMAS) 2M3PB
These are the MOST ACCURATE method of measuring adherence because they record the date and time the medication bottle was OPENED THROUGH MICROPROCESSOR technology embedded in the cap. (GIVE THE disadvantages of this)	Medication Event Monitoring Systems (MEMS) Disadvantages: 1 erroneous/not faith/falls., because pt may remove more than one dose 2 Very expensive & different devices are needed for each medication 3 Therefore it is an impractical way to determine adherence in clinical practice.
is EASIEST METHOD when adherence is being assessed, OPEN-ENDED QUESTIONS should be asked. Instead of asking, “Are you taking your medications?” the HCP should phrase the question along the lines of, “How many times in the past week (month) have you skipped your medications?”	Patient Self-reports
A method FAR MORE FEASIBLE OPTION for CLINICAL PRACTICE employed in RESEARCH	Blood Levels
Method DESIGNED TO DISTINGUISH POORLY ADHERENT PATIENTS from those with MEDIUM TO HIGH ADHERENCE to their ANTIHYPERTENSIVE REGIMEN consists of QUESTIONS ADDRESSING MULTIPLE REASONS FOR NON ADHERENCE The SCALE CONTAINS A QUESTION assessing whether the PATIENT FEELS HASSLED ABOUT THE REGIMEN Questions are PHRASED to avoid BIAS Question MEASURES MEDICATION TAKING BEHAVIOR rather than adherence/ compliance behavior	Morisky's Medication Adherence Scale (MMAS)
Methods that can improve Medication Adherence by Pharmacists iisa ang method	1 Improve PHARMACY WORKFLOW 2 SIMPLIFY Patient’s Medications 3 IDENTIFY REASONS for Medication Non-adherence 4 ASK PATIENTS SPECIFIC QUESTIONS about their Medication IISA
ROLE of Pharmacists in ADHERENCE	1 PX education 2 Dosing simplification & minimization of A/E 3 Preparing a dosing card PDP
Contains ONLY THE MOST ESSENTIAL ELEMENTS of a PATIENT'S MEDICATIONs; highly beneficial HELPFUL FOR patients who take medications or who have COGNITIVE BARRIERS	Dosing Card