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Nursing Concept Analysis

3709 words - 15 pages

Adherence: A Concept Analysis
Tiffany Bruno

Adherence: A Concept Analysis
The concept of adherence to medication regimens has been an ongoing area of study across medicine, psychology, nursing and pharmacology. First, I think it is important to clarify the difference between compliance and adherence. The term “adherence” implies a more collaborative active role between the patients and their providers whereas compliance implies a passive role to health-care on the part of the patient (Carpenter 2005).
The word adhere originated in the 15th century from the Latin “’ad-“ (to) + “haerere” (to stick)” (The American Heritage College Dictionary, 1993, p. 16). Adhere is defined as ...view middle of the document...

Review of Literature
Nursing
Schaffer & Yoon (2001) describe medication adherence as a collaborative, interactive patient-provider relationship. Medication adherence is the degree of consistency between the prescribed regimen and the patient's actual dosing history (Schaffer & Yoon, 2001). Medication adherence is important as it provides not only a better clinical outcome for the patient, but has been shown to reduce healthcare costs associated with unnecessary hospitalization and emergency room visits (Schaffer & Yoon, 2001). Several characteristics of medication adherence were identified in the article (Schaffer & Yoon, 2001). First, patients with a clear understanding of the purpose of the drug and how to properly take the drug were more likely to adhere (Schaffer & Yoon, 2001). Second, medication adherence increased when the patients believed in the medication’s efficacy and had confidence in his/her ability to adhere to the regimen as prescribed (Schaffer & Yoon, 2001). Financial constraints, such as lack of insurance or low income, also negatively affect adherence (Schaffer & Yoon, 2001). Patients that experience adverse effects; are in the early stage of treatment; and busy, middle-aged adults are less likely to adhere to a treatment regimen (Schaffer & Yoon, 2001). It is necessary that the clinician allows the patient to openly discuss concerns or raise questions regarding the medication or condition, share treatment goals and anticipate barriers to adherence while equipping the patient with tools to overcome the obstacles related to adherence (Schaffer & Yoon, 2001). Schaffer and Yoon (2001) also point out that regimens with two or more doses per day have lower rates of adherence. Strategies such as establishing a good provider-patient relationship to increase emotional rapport, positive conversation and clearly informing the patient of the medication and condition will increase adherence (Schaffer & Yoon, 2001).
A study done by Van Camp, Huybrechts, Van Rompaey and Elseviers (2011) evaluated the relationship of adherence to phosphate binders for chronic dialysis patients. Psychological factors such as anxiety about potential side effects or adverse events, perceived benefits of taking the medication and confidence in taking the medication were the main barriers of adhering to the regimen (Van Camp, et al., 2011). The Medication Event Monitoring System (MEMS) was used to measure patient adherence to phosphate binders over the 17 weeks (Van Camp, et al., 2011). The MEMS devise is able to capture the date and time the medication pill box was opened and presumed that the phosphate binder was taken (Van Camp, et. al., 2011). Electronically monitoring medication adherence has shown to be effective as the patient is aware of the intervention, hence more likely to adhere because of the monitoring (Van Camp et al., 2011). The increased adherence based on the MEMS microchip was...

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