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Medication Regimens and the Home Care Client: A Challenge for Health Care Providers
Published in Barbara J. Horn, Facilitating Self Care Practices in the Elderly, 2019
Betty L. Pesznecker, Carol Patsdaughter, kimberly A. Moody, Marilynn Albert, Jana R. Ostrom, Kathleen MA O’Connor
Provider/Treatment focused factors are those which involve either the interaction between provider and patient or characteristics of the treatment itself. Factors shown to be related to non-compliance in this category include: (a) ineffective communication reflected by client’s level of understanding of medications and regimen, (b) client’s lack of confidence in the provider, (c) lack of monitoring strategies and feedback, and (d) absence of written instructions (Lipton, 1982; Haynes, Taylor, & Sackett, 1979). In a study by Hulka, Cassell, Kupper, and Burdette, (1976), physician-patient pairs were examined to determine the extent to which noncompliance could be attributed to inadequate communications. When patients were given more and better information about their drugs, their compliance was significantly better. Evans and Spelman (1983) reported that compliance was improved by providing clients with more understandable information and by supplying written information, which resulted in increased knowledge of their regimen. They also found that the attitude of the doctor seemed to facilitate compliance. In another study reported by Christensen (1978), physicians were found to exhibit four compliance-gaining strategies: friendliness, medical authority, justification of medication use, and emphasis on the need to continue taking the medication. Extensive monitoring and follow-up activities also contributed to increasing compliance. Although the dynamics of the client-physician interaction requires more study, there is sufficient evidence to suggest that it is a key factor related to non-compliance.
Enacting Care: Successful Recruitment, Retention, and Compliance of Women in HIV/AIDS Medical Research
Published in Nancy L. Roth, Linda K. Fuller, Women and AIDS, 2014
Nancy L. Roth, Myra Shoub Nelson, Carol Collins, Pamela Emmons, Mary Alderson, Frank Hatcher, Barbara Nabrit-Stephens, Mary Ann South
Compliance refers to the extent to which participants in clinical trials appear for scheduled appointments, take the appropriate quantity of the drug on trial, at the appropriate times and for the prescribed period of time, and otherwise engage in the behaviors required by the study protocol. It is generally suggested that there is a relationship between the communication of caregivers and study participants and the outcomes of a clinical trial—including participant compliance (Kreps, O’Hair, and Clowers, 1994; Kroger, 1994). However, work by Burgoon et al. (1987) suggests that while there is a strong association between communication factors and patient satisfaction, the relationship between communication and compliance gaining strategies employed is weak. They note that while research consistently shows that patients’ understanding of their situation is positively related to compliance, “how the medical practitioner communicates with the patient may be more important than the content itself” (Burgoon et al., 1987). They note that the extent to which a provider engages in relational communication—that which demonstrates how s/he feels about his/her relationship with a patient—may have a stronger influence on compliance than what the provider says.
How to say “no” most effectively: Evaluating resistance strategies for prescription stimulant diversion to inform preventive interventions
Published in Journal of American College Health, 2020
Laura J. Holt, Ty S. Schepis, Alison Looby, Eliza Marsh, Paige Marut, Richard Feinn
There are several opportunities for future research, including use of role-plays in laboratory settings, where prescribed students could employ different resistance strategies in response to requests for their medication. Laboratory simulations would be especially helpful in determining whether some resistance strategies are more effective when the student requesting medication continues to apply pressure after an initial refusal and/or the person making the request uses multiple compliance-gaining strategies (eg, rational-academic, negative feelings). Simulations and qualitative research also might identify resistance strategies not yet reported in the literature. Longitudinal research could establish which resistance strategies are associated with lower diversion risk over time among students with prescriptions and track changes in relationships that occur with use of resistance strategies. This research could inform the development of a preventive intervention that promotes the most effective strategies for resisting requests for their medications, thereby limiting stimulant diversion and NMUPS on college campuses. Prior research evaluating drug and alcohol use prevention programs, such as the “Drug Resistance Strategies Project” (also called keepin’ it REAL), has demonstrated that adolescents’ resistance skills for cigarettes and marijuana could be enhanced via an intervention.34 Whether these skills are malleable at a different developmental stage (emerging adulthood) and for a different behavior (stimulant diversion) are open questions, however.