Approaches in Psychology - Essay Example

Adherence Adherence has been defined in many different ways. For example, Lois Eldred, from Johns Hopkins AIDS Services, defines adherence very broadly "as the extent to which a patient's health-related behaviours correspond with medical advice." Amongst these health-related behaviours, keeping medical appointments and taking prescribed medications (Marer, 1997). Adherence can also be defined as the extent to which a patient's behaviour coincides with medical advice (Haynes et al, 1991). Adherence to any medication for a period is largely influenced by the person's perception of the risks, benefits, and costs of the medication (Love et al, 1991).

Costs may not only include financial matters but also the potential side effects of the medication. Adherence rates for many long-term drug therapies have been very low, usually not more than 40%-50% (qtd. from Partridge et al, 2002). Clinicians generally assume that patients are taking drugs as prescribed and, if they discuss the topic with their patients at all, believe their patients when they say they are taking their medications as prescribed (Partridge et al, 2002). Adherence to treatment is a compound and many-sided issue that could affect the outcomes of the treatment (qtd.

from Partridge et al, 2002). Adherence should not be confused with compliance. Compliance implies a passive role and following demands of prescriber, whilst adherence implies a more active role in collaboration with the prescriber with further self-motivated decision to follow treatment advice and self-regulation of illness and treatment (Compliance vs. Adherence, 2005). The health psychology study on the factors that affects adherence and the necessary intervention to improve adherence is very important because non-adherence can contribute greatly to the variability observed in a drug's therapeutic effect if the clinician incorrectly attributes the patient's worsening condition to an absence of drug activity (Avorn et al, 1998).

This flawed conclusion may lead to unnecessary diagnostic testing, hospitalizations, and changes in dose or regimen. Non-adherence has also been associated with an increase in physician visits, higher hospitalization rates, and longer hospital stays (qtd. from Partridge et al, 2002). In the 1990s, there was an increased interest in understanding and improving adherence with taking prescription medications. This is at least in part due to the recognition that non-adherence to medication could lead to the emergence of resistance to antimicrobial therapy for diseases such as tuberculosis and human immunodeficiency virus (HIV) infection (Anastasio, 1995, also in Sumartojo, 1993).

Furthermore, in an increasingly cost-conscious medical-economic environment, the costs of medication non-adherence are high. Nearly 10% of hospitalisations are attributed to drug therapy non-adherence (Hussar, 1994). Moreover, non-adherence can compromise the patient-doctor relationship, because misunderstandings about the results of a therapy on the part of either the patient or the provider could lead to a collapse in communication and adversely affect the patient's concept on therapy (Waterhouse et al, 1993).

Health psychology is a quite new field of applied psychology. Psychological principles are used to promote changes in people's attitudes, behaviour and thinking about health and illness. The scope of the discipline include the study of the processes influencing health care delivery; the nature and effects of communication between doctors and patients, including interventions to improve communication, assist adherence, prepare for stressful medical procedures and so on (Health Psychology, 2004).

Most experts believe that it takes a concerted effort between patients and health care providers in order for adherence to be successful. Some used to think that adherence is a kind of personality trait: some people are good at it; some are not. However, this is only half of the story: there are things patients and health care providers can do to enhance adherence (Marer, 1997).ReferencesAnastasio CJ. (1995). HIV and tuberculosis: noncompliance revised. J Assoc Nurses AIDS Care; 6:11-23 Avorn J, Monette J, Lacour A, Bohn RL, Monane M, Mogun H, et al. (1998). Persistence of use of lipid-lowering medications: a cross-national study.

JAMA, 279:1458-62.Compliance vs. Adherence. (2005). Retrieved 12 Dec. 2005, from http://www.unc.edu/tbrock/Merck%20Program/tsld018.htm.Haynes RB, Taylor DW, Sackett DL, editors. (1979). Compliance in health care. Baltimore (MD): The Johns Hopkins University Press.Health Psychology. (2004). The British Psychological Society. Retrieved 12 Dec. 2005, from http://www.bps.org.uk/careers/areas/health.cfmHussar DA. (1994). Patient compliance: the ongoing challenges facing pharmacy. AmDruggist; 211:83-90KA, Mele C, Brenner DE. (1993). Adherence to oral tamoxifen: a comparison of patient self-report, pill counts, and microelectronic monitoring.

J Clin Oncol, 11:1189-97.Love RR, Cameron L, Connell BL, Leventhal H. (1991). Symptoms associated with tamoxifen treatment in postmenopausal women. Arch Intern Med, 151:1842-7.Waterhouse DM, Calzone Marer, Marcelo. (1997). Simply Medical -- HIV Treatment: The Importance of Adherence.Retrieved 12 Dec. 2005, from http://www.thebody.com/bp/oct97/treatment.htmlPartridge, Ann H., Jerry Avorn, Philip S. Wang, and Eric P. Winer. (2002). Adherence to Therapy With Oral Antineoplastic Agents. Journal of the National Cancer Institute, Vol. 94, No. 9, 652-661.

Sumartojo E. (1993). When tuberculosis treatment fails. a social behavioral account of patient adherence. Am Rev Respir Dis; 147:1311-1320