Adherence And Treatment Of Depression

3037 Words13 Pages
Running head: Increasing Adherence

Why Bother?: Increasing Adherence in Depressed, Chronically Ill Patients
Sandra Strait
Excelsior College

Abstract Adherence to medical advice is poor in chronic illness. Depression is a common and under-addressed problem in chronic illness that decreases adherence. Identification and treatment of depression can improve compliance. According to health behavior models people are unlikely to make changes unless they see a benefit. A multifaceted approach to providing information, assisting with motivation and stategizing with the patient when prescribing medical advice will help the patient understand what changes they can make that will lessen symptoms and improve their condition.
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“The odds of having good health outcomes are 2.88 % higher when patients are adherent” ( DiMatteo, Haskard-Zolnierek & Martin, 2012, p. 75). Nonadherence occurs for many reasons and may or may not be intentional. Nonadherence is defined as the failure to follow prescribed medical advice. Examples of actions considered to be medical advice are: to take medication as prescribed, make behavioral changes such as diet and exercise, keep appointments, and have screenings/testing done. Nonadherence, also called noncompliance also causes frustration of providers and patients, and wastes resources. Rates of nonadherence can be as high as 70% with complex regimens (Martin, Williams & DiMatteo, 2005). Factors in compliance with medical advice include: severity of disease, complexity of regimen, patient knowledge and beliefs, costs incurred by the patient, resource availability, availability of social support, psychological problems, and rapport and communication with healthcare providers. Nonadherence rates are 27% higher for patients with depression. (Martin, et al.). “The prevalence of depressive disorders in chronic medical illness is 1.5 to 4 times higher than the general population (DiMatteo, 2012). Depression is one of the strongest predictors of patient nonadherence (DiMatteo 2000, Martin). Depressed patients experience feelings of hopelessness, worthlessness, loss of energy, loss of interest and enjoyment, weight changes, sleep disorders,
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