Patient-Related Factors Affecting Adherence
{"Image DocumentName": "Patient-Related Factors Affecting Adherence", "Image ImageDescription": "Inadequate education1; inadequate skills/knowledge to follow regimen2. Patients\u2019 main concerns. Uncertain nature of IBD. Effects of medications3. Patients\u2019 belief systems (treatment will not help, side effects outweigh benefits)2. Psychiatric disorders4. Male, unmarried, younger age5,6. Patterns of nonadherence7. Ultimately, it is the patient who will or will not adhere to the treatment regimen. An inadequate education111 and inadequate ability to follow a treatment regimen112 are factors that have been found to decrease patient adherence. If the patient understands the need to treat the disease \u2013 in other words, that it will not go away by itself \u2013 and also understands that the proposed treatment regimen, if followed carefully, will lead to important improvement in the way she feels, she is more likely to adhere to treatment. Unfortunately, the uncertain nature of IBD and the adverse effects that some medications produce reduce many patients\u2019 confidence in the efficacy and safety of the treatment regimen.9,110. Treatment needs to be individualized to the patient, and some patients, such as those with psychiatric disorders113 or younger, unmarried men, will pose greater adherence problems than others In addition, there are some specific patterns of nonadherence. Patients may not fill a prescription to begin with or may fail to refill it. They may forget or skip doses or exceed the prescribed dose on the theory that if a little is good, more must be better. They may take the medication at incorrect intervals, such that the desirable steady-state serum level is not achieved; and they may administer the medication incorrectly, as with drugs that are to be taken via enema Martin A, et al. Ital J Gastroenterol. 1992;24: Levy RL, Field AD. Am J Gastroenterol. 1999;94: Drossman DA, et al. Psychosom Med. 1991;53: Nigro G, et al. J Clin Gastroenterol. 2001;32: Kane S. Am J Gastroenterol. 2001;96: Kane S. Am J Gastroenterol. 2001;96(suppl):S296. 7Kane S. In: Bayless TM, Hanauer SB, eds. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: BC Decker, 2001:9-11.", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}