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Drug Compliance and adherence: A Public Health Perspective

Timothy E. Gibbs, BA, NPMc Executive Director, Delaware Academy of Medicine. Drug Compliance and adherence: A Public Health Perspective. Objectives. At completion of this presentation the audience will understand: The importance of drug regime compliance

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Drug Compliance and adherence: A Public Health Perspective

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  1. Timothy E. Gibbs, BA, NPMcExecutive Director, Delaware Academy of Medicine Drug Compliance and adherence: A Public Health Perspective

  2. Objectives At completion of this presentation the audience will understand: • The importance of drug regime compliance • How adherence and compliance are similar, yet different • Identifying barriers to, and negotiating adherence with patients needing medication. • How non-compliance is similar to drug “abuse”

  3. An estimated 50% of all patients do not take medications properly: • Right dose, • Right time, • Right conditions

  4. When patients are asymptomatic . . . Non-compliance rates increase dramatically to an estimated 75% percent.

  5. Providers tend to OVERESTIMATE medication compliance

  6. Compliance and Adherence Similar meanings, but different connotation: “Comply” means something like “Do what I tell you” “Adhere” means something like “Stick to the plan”

  7. The word “Compliance” defines • A power dynamic between provider and patient • Patient has less control • Patient has greater opportunity to “fail”

  8. When patients fail to COMPLY— Blame is placed on the patient rather than the provider.

  9. Barriers to Adherence • Economic • Social • Behavioral • Environmental • Cultural • Biological

  10. Barriers to Compliance: Confusing and conflicting drug regimes may be a substantial barrier.

  11. Recognizing Another Barrier Healthcare Provider-Patient Relationship Must be based on mutual respect and trust . . .

  12. 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

  13. When patients believe in the Treatment Plan • They adhere to the medication regime AND • They seek out support for lifestyle changes, like • DIET • EXERCISE

  14. Providers Need to LISTEN to and ADDRESS patients’: • Fears • Lifestyle concerns • Social and family issues TEACH patients about: • Disease process • Medication side effects

  15. Opportunities to reduce barriers • Health education • provider/patient relationship and negotiating • Better protocols with fewer side effects • Cues to non-adherence

  16. How does Medication Non-Adherence compare to 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 Non-Adherence Drug Abuse

  17. Legal Concerns If 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?

  18. Further Research is Needed To bridge the gap between what it means to take a drug to feel good, versus taking a drug to be well.

  19. Conclusion/Questions

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