On Thursday 25th of August 2016, I completed the cardiac care IPL activity. During the activity, I was grouped with a pharmacy student and an exercise physiology student. The patient “Craig Williams” was to have a med check by the pharmacy students and review his home exercise program by the exercise physiology student and to seek a solution for his compliance. During the med check by the other pharmacy student, the patient informed us that he hasn’t been compliant with a couple of his medications which got me concerned. It made me think why he has stopped taking these medications and how this would impact him while on his health condition. Thinking back to my prior learning on medication noncompliance, patients who don’t take their medications
The cardiology ward is an area were patients are experiencing heart and circulatory issues; it is a mixed sex bedded unit for patients diagnosed with acute and chronic cardiac conditions; the team liaise with the cardiac rehab
This ultimately can affect mortality. About five percent of re-admissions are directly driven by lack of adherence to medications as prescribed by the healthcare providers. It is concerning for seniors as living costs continue to rise and their income fixed income remains stagnant.
Other situations that could arise could be around a young adult not wanting to take their medication but not understanding the importance of the medication and the consequences of not taking it, if it is for something like epilepsy or depression.
Some of the factors that patients do not adhere to when their healthcare provider tells them too is due to patients being too busy. Often times life is very busy as we all know this but forgetting to take of yourself can have detrimental effects to your health. Some people think they can get better on their own without the help of a doctor so they feel like they will be fine or able to handle any health complication on their own. Another reason is that often people do not understand or they forget what the doctor is telling them about their prescribed treatment regimens and other patients decide to simply not follow it. As stated in the article by Sklar, Min Sen Oh & & Chuen Li, 2008 “Poor communication with healthcare providers was also likely to cause a negative effect on patient’s compliance (Bartlett et al 1984; Apter et al 1998)”. Miscommunication between a doctor and patient is at the root of most adherence problems. Often times patients leave their doctors office not knowing or having the slightest clue to what they should be doing. Instead of asking for help or clarity they just leave. Communication needs to be clear and effective for both the patient and the doctor. Non-adherence is wide spread when it comes to patients not adhering to what professionals tell them. Many patients will have significant risks because they forget,
Implement measures to improve cardiac output: perform actions to reduce cardiac workload: place client in a semi- to high Fowler's position, instruct client to avoid activities that create a Valsalva response, implement measures to promote emotional and physical rest, implement measures to improve respiratory status, discourage smoking, provide small meals rather than large ones,
If an individual expresses that they want to discontinue their medication and becomes non-compliant with their medication then it is my role to identify the risk they are currently posing and update their risk assessment; inform their CMHT and let the citizen know of the consequences to them not taking their medication and reiterate that it is their choice, as long as they have all the information to make a decision (wise or unwise). It is important to emphasise that not all individuals understand information the same way, therefore I have found that the use of internet, booklets, music, audio recordings, talking group therapy and pictures can be applied to explain a situation to a resident if they are unsure of particular consequences to their health.
drugs can be potentially dangerous for a patient, particularly if they are receiving medications from different clinicians who are not communicating with each
The activity that I performed and relates to this outcome is medication reconciliation. I performed this activity in my IPPE-III class as a PS-III student. It was a mandatory activity, which I carried out in workshop in the group of 4 students. In this activity, we were given a patient case, which had list of all the medications that patient was taking and had patient’s demographic information. After reviewing patient’s given information, I had to interview a standardized patient and find out if the patient is taking all the medications as directed by prescriber or not. If patient is taking any other vitamins, herbal or OTC medications that is not on the list and also had to look out for if there is any discrepancy with the medications patient currently on for example, duplicate therapy, drug-drug interaction, incorrect frequency etc.
Post hospital stay and admission of the cardiac patient post cardiac event will be provided education on cardiac rehabilitation programs. The length of cardiac rehabilitation programs differ according to the cardiac patient’s condition, cardiac health needs the patient requires and the cardiac event the patient has encountered. Cardiac rehabilitation programs are provided in an outpatient clinic or may also be implemented in the cardiac patients home. Cardiac rehabilitation in a patient’s home is inclusive of, telephone support, online Heart Education Assessment and Rehabilitation Toolkit (HEART), and home visits from services in the community, (Recommended Framework for Cardiac Rehabilitation, 2004). Cardiac rehabilitation programs require expertise from a range of professionals from the multidisciplinary team including, a cardiologist, a cardiac rehabilitation nurse, physician, dietician,
“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.
M.G., a “frequent fl ier,” is admitted to the emergency department (ED) with a diagnosis of heart failure
The provision of written medication information given to the patient helps significantly in cases of medication non compliance (McGraw & Drennan 2004). This is because it aids in memory retention and presents patients with access to a reliable source of concise medication information, particularly if the patient needs to be reminded of certain aspects (Gorgos 2006). These written medication information sheets need to be provided in the patients primary, dominant language because it reduces the difficulty and limits barriers to patient understanding (Gorgos 2006).This is important because this intervention aims to increase a patient’s understanding of their medications, and when a patient feels more competent with the use of their medications, reduced
Moreover, I learned how to use a Doppler to measure blood pressure and the process of evaluating new patients. I took patients’ weight once a week and their blood pressure. I have also observed the exercise physiologist conduct the 6-minute walk test to know patients’ tolerance to exercise. Patients rotate through three exercise stations, including the walking track, treadmills, recumbent bikes, airdyne bikes, rowing machines, and weights. The duration and intensity of the exercise is individualized prescribed for each patient. Lastly, I tried to learn many aspects of the cardiac rehabilitation to improve the overall quality of patient’s life and increase my knowledge on cardiac rehabilitation. I had a great learning experience in my internship
First goal: Patient will verbalize understanding of the importance of follow her heart medication regime as doctor prescribed it and describe the possible consequence of a non-compliance with her treatment by the end of her today’s appointment.
Cardiac rehabilitation programme is structured to be either hospital based, community based or home based. It was recommended by WHO, (1993) that cardiac rehabilitation should start at the time of coronary heart disease, or