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Adherence to Medications Susan E. Fleming, MN, RN Michele Wolfe, MN, ARNP Cindy Corbett, PhD, RN

Adherence to Medications Susan E. Fleming, MN, RN Michele Wolfe, MN, ARNP Cindy Corbett, PhD, RN. Susan E. Fleming, MN, RN Michele Wolfe, MN, ARNP Cindy Corbett, PhD, RN. Learning Objectives. Describe adherence & co-morbidity Identify WHO’s Five Dimensions to Medication Adherence

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Adherence to Medications Susan E. Fleming, MN, RN Michele Wolfe, MN, ARNP Cindy Corbett, PhD, RN

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  1. Adherence to Medications Susan E. Fleming, MN, RN Michele Wolfe, MN, ARNP Cindy Corbett, PhD, RN

  2. Susan E. Fleming, MN, RNMichele Wolfe, MN, ARNPCindy Corbett, PhD, RN

  3. Learning Objectives • Describe adherence & co-morbidity • Identify WHO’s Five Dimensions to Medication Adherence • Describe self-management support strategies for overcoming barriers to medication adherence.

  4. Patient Adherence to Medications

  5. Adherence • Mosby’s Medical Dictionary defines adherence as “the process in which a person follows rules, guidelines, or standards, especially as patients follow a prescription and recommendations for a regimen of care”

  6. Co-morbidity Primary disease + One or more diseases = Co-morbidity

  7. Self Management Support • Demonstrating new skills • Praise & Feedback

  8. Self-Management

  9. Chronic Care Model

  10. Global Medication Adherence is 50%

  11. WHO’s Five Dimensions of Adherence

  12. 1. Social & Economic

  13. 1. Social & Economic • Community Support

  14. 1. Social & Economic • Economic

  15. 1. Social & Economic Prescription for Medication • Pictures • Use pictures when giving instructions • Read Back • Have the patient read back the instructions

  16. 1. Social & Economic How to make an Economic Poster from a PowerPoint Slide • Go to PowerPoint • Use Graphics and Make a Poster • Take a thumb drive or disc to a Print Shop and make a poster.

  17. 1. Social & EconomicUse Pictures When Teaching

  18. 2. Health Care System • Provider-Patient Relationship

  19. 2. Health Care System • Using two-way communications and asking open ended questions fosters encouragement.

  20. 2. Health Care System • Shared Decision Making

  21. 3. Condition Related • Chronic conditions, such as hypertension, that lack symptoms highly impact the level of adherence

  22. 3. Condition Related • People’s belief about the benefits and risks of medications influence whether they abide by a regimen.

  23. 4. Therapy Related • Therapy-related factors include the complexity of medication regimen and unpleasant side effects.

  24. 4. Therapy Related • Dosing several times a day may contribute to non-adherence.

  25. 4. Therapy Related • Concern about medication side effects remains a powerful barrier.

  26. 5. Patient Related • Perception of need, medication effectiveness, and safety.

  27. 5. Patient Related • Follow up Appointments

  28. 5. Patient Related • Personalized education and counseling sessions delivered by telephone, intranet, or in person by trained personnel.

  29. Conclusion

  30. QUESTIONS AND DISCUSSION?

  31. References • Agency for Healthcare Research and Quality. (2002). Preventing Disability in the Elderly with Chronic Disease. Retrieved May 15, 2010, from http://www.ahrq.gov/research/elderdis.htm. • Chronic Care Model (2010). The Chronic Care Model. Retrieved June 15, 2010, from http://www.improvingchroniccare.org/index.php?p=The_Chronic_Care_Model&s=2 • Goldberg, E., Dekoven, M., Schabert, V., et al. (2009). Patient Medication Adherence: The Forgotten Aspect of Biologics. Biotechnology Healthcare, 39-44. • Murray, M., Morrow, D., Weiner, M., et al. (2004). A Conceptual Framework to Study Medication Adherence in Older Adults. The American Journal of Geriatric Pharmacotherapy, 2(1), 36-43

  32. References continued. • Ruppar, T., Conn, V., & Russell, C. (2008). Medication Adherence Interventions for Older Adults: Literature Review. Research and Theory for Nursing Practice: An International Journal, 22(2) 114-147. • Sherman, B., Frazee, S., Fabios, R., et al. (2009). Impact of Workplace Health Services on Adherence to Chronic Medications. The American Journal of Managed Care, 15(7), 53-59. • Simpson, R. (2006). Challenges for Improving Medication Adherence. The Journal of the American Medical Association, 296(21), 2614-2616. • World Health Organization. Adherence to Therapies: Evidence for Action. Geneva: World Health Organization, 2003

  33. ContactInformation • Susan Fleming, MN, RN, PhD student • sefleming@wsu.edu • Michele Wolfe, MN, RN • bluchel1@msn.com

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