Engagement and concordance

compliance

the extent to which a person behaviour (in terms of taking medication, following diets or executing life style changes) coincides with medical or health advise

• one way relationship / no considerations agreement

Adherence

the extent to which a person behaviour - taking medication, following a diets, and / or executing lifestyle changes, corresponds with agreed recommendations from a health care provider

• active and involved patient role, but professional directed

concordance

the process of developing a mutually agreed treatment plan

• agreement / harmony shared decision

Adherence failure

• failed to take medication as required

• Missed a medical appointment

• Skipped rehabilitation exercises

• Not following lifestyle advise

Consequences for non-adherence

• economic- waste of medical resources, costly treatment see effects and repeated doctor and special visits

• Clinical - majority of health care regiment will not work if the patient chooses not to adhere, adherence is associated with positive outcome from their hospital experience

• Many diseases and illnesses are only preventable or treatable

potential barriers to adherence

• low levels of physical activity

• Low in treatment adherence with exercise

• Low self efficacy

• Depression and / or anxiety

• Helplessness

• Poor social support / activity

• Increased pain during exercise

However, predictors to better physical health, less fear of falling and younger people

what can influence adherence behaviour ?

• social factors - eduction, unemployment, low social support

• Psychological factors - high anxiety and depression, coping styles and interruption to daily routine

• Treatment factors - misunderstandings, complexity, side effects, little obvious benefit, poor health etc

assessing and measuring adherence

Encouragement (promoting)

• good communication (written and verbal)

• Education

• Share resources

• Provide easily accessible assistance

• Identify and address barriers

• Recognise patients and their experiences

• Work in partnership with patient