| 1. SOCIAL AND ECONOMIC DIMENSION
give examples | 1 LIMITED ENGLISH PROFICIENCY
2 LOW HEALTH LITERACY
3 LACK OF FAMILY AND SOCIAL SUPPORT NETWORK
4 UNSTABLE LIVING CONDITIONS
5 burdensome schedule
6 LIMITED ACCESS to healthcare facilities
7 lack of health care insurance
8 inability/DIFFICULTY ACCESSING PHARMACY
9 MEDICATION COST
10 cultural and lay beliefs
11 elder abuse |
| HEALTH CARE SYSTEM DIMENSION
give examples | 1 PROVIDER-PATIENT RELATIONSHIP
2 PROVIDER COMMUNICATION SKILLS
3 disparity between the health beliefs of the health care provider and those of the patient
4 LACK OF POSITIVE REINFORCEMENT from healthcare provider
5 WEAK CAPACITY of the system TO EDUCATE PX AND FOLLOW UP
6 LACK OF KNOWLEDGE ON ADHERENCE and of effective interventions for improving it
7 px information materials written at HIGH LITERACY LEVEL
8 restricted formularies; changing meds covered on formularies
9 HIGH DRUG COST
10 POOR ACCESS OR MISSED APPOINTMENTS
11 LONG WAIT TIMES
12 LACK OF CONTINUITY OF CARE |
| CONDITION-RELATED DIMENSION
give examples | 1 chronic
2 lack of symptoms
3 severity of symptoms
4 depression
5 psychotic disorders
6 mental retardation/ developmental disability |
| THERAPY-RELATED DIMENSION
give examples | 1 COMPLEX MEDICATION REGIMEN
2 TREATMENT REQUIRES MASTERY of certain techniques
3 DURATION OF THERAPY
4 FREQUENT CHANGES IN MED REGIMEN
5 LACK OF IMMEDIATE BENEFIT OF THERAPY
6 medications with SOCIAL STIGMA attached use
7 ACTUAL OR PERCEIVED UNPLEASANT SIDE EFFECTS
8 TREATMENT INTERFERES WITH LIFESTYLE or requires significant behavioral changes |
| PATIENT-RELATED DIMENSION
give examples | PHYSICAL FACTORS
- visual, hearing, cognitive, mobility impairment
- swallowing problems
PSYCHOLOGICAL/BEHAVIORAL FACTORS
- knowledge about dx
- perceived risk
- understanding reason meds is needed
- attitude toward treatment
- confidence in ability to follow treatment regimen
- motivation
- fear of possible a/e
- fear of dependence
- feeling stigmatized by the dx
- frustration w/ health care providers
- stress, anxiety
- alcohol or susbtance use |
