Adherence

•Compliance
denote a relationship in which the patient has a passive role and is expected to follow the doctor’s orders

•Adherence
patient asking about the treatment to doctor, before follow the doctor’s orders.

•Concordance
denote the degree to which the patient and health practitioner agree about the nature of the illness and need for treatment

 

Five interacting dimensions affect adherence

1.Social and economic Factors

  - low level education

  - lack of effective social support networks

  -  long distance from treatment center

  -  high cost of transport

  -  high cost of medication

2.Health Care Team and System-related Factors

  -  Poor medication distribution system

  -  Lack of knowledge and training for health care providers on managing chronic diseases

  -  Short consultation

  -  Weak capacity of the system to educated patients and provide follow-up

3.Conditional-related Factors

  -  Related severity of symptom

  -  Level of disability (physical,mpsychological, social and vocational)

  -  Rate of progression and severity of the disease

  - The availability of effective treatments

4. Therapy-related Factors

  -  Related to the complexity of the   medical regimen

  -  Duration of treatment

  -  Previous treatment failures

  -  Frequent changes in treatment

5. Patient-relate Factors

  -  Forgetfulness

  -  Psychosocial stress

  -  Low motivation

  -  Misunderstanding and  non-acceptance of the disease              

  -  Hopelessness and negative feelings

  -  Fear of dependence

 Role of Pharmacist:

•Giving inform to the patient of the benefits and importance of compliance to achieve treatment success

•Giving confidence to the patient to the drug's effectiveness in healing

Reference :

Gard, P.R. 200. A Behavioural Approach to Pharmacy Practice. Oxford: Blackwell Publishing

WHO. 2003. Adherence to Long-Term Therapies: Evidence for Action