(DOWNLOAD) "Treatment Adherence." by South African Journal of Psychiatry ~ eBook PDF Kindle ePub Free
eBook details
- Title: Treatment Adherence.
- Author : South African Journal of Psychiatry
- Release Date : January 01, 2007
- Genre: Health & Fitness,Books,Health, Mind & Body,
- Pages : * pages
- Size : 186 KB
Description
The term 'adherence' is often used incorrectly and synonymously with the term 'compliance'. (1) Compliance is the extent to which a patient's behaviour coincides with the medical prescription and recommendations. (2) Adherence, on the other hand, refers to the willingness and ability of patients to follow health-related advice, to take medication as prescribed, to attend scheduled appointments, and to complete recommended investigations. Compliance implies an obligation on the part of the patient to blindly follow the practitioner's instructions, while adherence implies a therapeutic alliance with the practitioner. Previously patients were classified as either adherent or non-adherent but now it is more evident that there is a continuum, with many patients showing some degree of adherence. Patients with psychiatric disorders show a greater degree of non-adherence to treatment than those with physical disorders. (3) The adherence rates range from 40-70% to 60-92% in the respective disorders. About 30% of all patients with psychiatric disorders discontinue their medication in the first month and 44% discontinue it within the first 3 months of initiation of treatment. (4,5) The recent CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) study (6) reports that patients on antipsychotics discontinue their assigned treatment because of inefficacy and intolerable side-effects of medication. In total, 74% of the 1 493 schizophrenia patients recruited discontinued their assigned study medication within 18 months of initiation. Of the newer atypical antipsychotics, olanzapine was found to be the most effective in terms of the rates of discontinuation compared with quetiapine, risperidone, and ziprasidone and conventional antipsychotic agents. Because of high discontinuation rates, the Diagnostic and Statistical Manual of Disorders (DSM IV TR) (7) has included 'non-compliance' as a condition that may be a focus for clinical attention.
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