timothy e. gibbs, ba, npmc executive director, delaware academy of medicine
TRANSCRIPT
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Timothy E. Gibbs, BA, NPMcExecutive Director, Delaware Academy of
Medicine
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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”
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An estimated 50% of all patients do not take medications properly:
•Right dose,
•Right time,
•Right conditions
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When patients are asymptomatic . . .
Non-compliance rates increase dramatically to an estimated 75% percent.
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Providers tend to OVERESTIMATE medication
compliance
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Compliance and AdherenceSimilar meanings, but different connotation:
“Comply” means something like “Do what I tell you”
“Adhere” means something like “Stick to the plan”
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The word “Compliance” defines
•A power dynamic between provider and patient
•Patient has less control
•Patient has greater opportunity to “fail”
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When patients fail to COMPLY—
Blame is placed on the patient rather than the provider.
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Barriers to Adherence
•Economic•Social•Behavioral•Environmental•Cultural•Biological
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Barriers to Compliance:
Confusing and conflicting drug regimes may be a substantial barrier.
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Recognizing Another Barrier
Healthcare Provider-Patient RelationshipMust be based on mutual respect and trust . . .
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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
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When patients believe in the Treatment Plan
•They adhere to the medication regime AND
•They seek out support for lifestyle changes, like
•DIET
•EXERCISE
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Providers Need to
LISTEN to and ADDRESS patients’:•Fears•Lifestyle concerns•Social and family issues
TEACH patients about:•Disease process•Medication side effects
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Opportunities to reduce barriers•Health education•provider/patient relationship and negotiating•Better protocols with fewer side effects•Cues to non-adherence
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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
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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?
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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.
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Conclusion/Questions