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Body
Published in Lisa Zammit, Georgeanne Schopp, Relational Care, 2022
Lisa Zammit, Georgeanne Schopp
A terminal diagnosis allows the patient to make decisions regarding the remainder of their lives (Siegel, 1998). Each Patient establishes their own priorities. Viewed as noncompliance by Clinicians, Patient needs may trump medical protocols. Incorporating Personhood in medical therapy acknowledges Body, Spirit, and Mind.
Journalology, Predatory Journals, Peer Review, Pre-Prints, and Guidelines
Published in Charles E. Dean, The Skeptical Professional's Guide to Rational Prescribing, 2022
While ClinicalTrials.gov has about two-thirds of global trial registrations, the authors provided a table of 16 internationally based trial registrations,56 echoing the growth of guidelines described earlier. Indeed, Europe maintains an EU Clinical Trials Register and an EU Trials Tracker that was set up in 2018.57 The data is similar, in that only 28% of over 13,000 completed trials had posted their results, violating the rule that requires posting of results within 1 year of trial completion. However, after the development of the Tracker system, compliance improved significantly, but the European Medicines Agency has pushed a new trial registry, the Clinical Trials Information System, which will come online in 2022, and impose new and stricter regulations, which may include legal action for noncompliance. Interestingly, Denmark already has a law that permits fines or imprisonment of offenders, although it has not been invoked!
Psychosocial approaches - 2 Enhancing recovery and staying well
Published in Kathy J Aitchison, Karena Meehan, Robin M Murray, First Episode Psychosis, 2021
Kathy J Aitchison, Karena Meehan, Robin M Murray
Up to 50% of schizophrenic patients fail to comply with their treatment.276,277 In one follow-up study of recent-onset manic patients, only 30% were found to be completely adhering to the treatment regime throughout the follow-up period.278 Young patients who don't yet accept the fact, or the seriousness, of their illness are often particularly loath to continue to take medication after recovery from their first psychotic episode. Unfortunately, noncompliance results in high relapse and rehospitalization rates with significant cost not only the patient but also to carers and to the services.
Investigating the effects of age, IQ, dosing, and anthropometric measures on the treatment persistence in long-term methylphenidate use
Published in Nordic Journal of Psychiatry, 2023
Mustafa Tuncturk, Cagatay Ermis, Dicle Buyuktaskin, Eren Halac, Ekin Sut, Oben Ozkan, Nazan Gundogan, Guldal Unutmaz, R. Ogulcan Ciray, Serkan Turan, Aynur Akay Pekcanlar
Treatment noncompliance is associated with various factors, such as the characteristics of the patient and caregiver, as well as healthcare system-related and drug-related factors [20]. Higher educational levels and a family history of ADHD were associated with better treatment compliance in adults [21]. Treatment adherence is also higher when both children and parents feel the improvement with treatment [22,23]. Considering MPH provides the highest benefit in the first month of treatment [24], the risk of drop-out in the long term has come to the fore. The fear of side effects, insufficient family support, and feelings of guilt from social environment pressure could affect parental decisions on ADHD treatment [25]. Severe hyperactivity/impulsivity, long-acting agents, polypharmacy, the absence of side effects, and perceived drug efficacy are also moderators of the treatment persistence [26]. In addition, adolescents with ADHD usually take their medication and are more likely to forget or stop taking medication; thus, the age at treatment onset, the number of pills taken in a day, and the type of formulation could also affect adherence and persistence [20,22,23,27]. Yet, little is known about the effects of anthropometric measures and intelligence quotient (IQ) on the treatment persistence.
Is regular in-person recall superior to non-regular in-person recall in clinical outcomes among new patients undergoing peritoneal dialysis
Published in Renal Failure, 2022
Ying Liu, Wen Xiu Chang, Ben-Chung Cheng, Jin-Bor Chen
The incidence of end-stage renal disease is increasing annually, and it is emerging as a critical health issue. Peritoneal dialysis (PD) is one of the two main modalities for renal replacement therapy in end-stage renal disease and is used by approximately 11% of the dialysis population worldwide [1]. PD offers home treatment and requires daily compliance and high involvement of patients and/or caregivers to guarantee favorable outcomes. To some extent, the choice to use PD is determined by patients’ subjective wishes. Adherence to treatment is critical because studies have shown that noncompliance to treatment can lead to increased costs for medical care [2–4]. In PD studies, noncompliance to treatment also has serious consequences including increased risk of mortality and hospitalization [5,6].
Medical Disobedience and the Conscientious Provision of Prohibited Care
Published in The American Journal of Bioethics, 2021
Compliance with the standard of care doesn’t by itself determine whether clinicians should be allowed to disobey a directive or break the law. Other practical, expressive, and democratic considerations matter too. Is care ruled out by a private institution or public one? By state law, or federal? What interests does that prohibition serve? Is the proscribed care a matter of life and death? Are other options available to those in need? Did consent come from the patient, or a guardian? Is defiance secret, or open? Have clinicians exhausted reasonable efforts to change the prohibition itself? Or shown it would be futile to work around it? The foreseeable consequences of noncompliance might make it intolerable. But there are circumstances in which I think health professionals should be let off the hook for conscientiously providing standard-of-care treatment that the rules forbid.