Reasons for non-adherence 1 and 2

• Why don’t people follow the advice of medical professionals?

  ·         Inconsistency in advice

  ·         Trust

  ·         Bad habits- might be hard to change

  ·         Is it feasible to follow advice?

  ·         Conflicting beliefs

  ·         Disagree

  ·         Personal ignorance
• What are 1 and 2 reasons for non adherence?

  1. Stress
  2. Rational non-adherence
• Stress as an explanation for non-adherence

  ·         People who are under stress are less likely to adhere to medical advice

  ·         People become stressed when they perceive that they cannot cope
• Ways stress may occur

  • Stress from poverty
  • Non adherence is higher/worse in lower socioeconomic groups
  • Stress is closely associated with chaotic lifestyles
  • Being diagnosed can be stressful, and stress can make people disorganised
  • In these circumstances, individuals often forget to take their medication or find it hard to follow medical advice
• Stressed clients

  Usually anxious, so their attention becomes narrower
• When speaking to professionals, these individuals may

  • Latch on to key words and ignore the rest
• What impact does stress have on your memory?

  Stress has a negative impact on your memory. Even if an individual understands the medical advice, adherence is impossible if they can’t remember it.
• Strengths of non adherence due to stress

  Support for effectiveness: stress is a reason for non adherence.
• Weakness of non adherence due to stress

  Although we know that stress impacts adherence short term, it Is unclear what the influence of stress is long term adherence
• Rational non-adherence


  Sometimes individuals chose not to follow medical advice for reasons they believe are logical, well considered and make sense.

  A rational decision is based on weighing u the costs and benefits of following or not following medical advice

  The main benefit of adhering is that it reduces or eliminates the symptoms of an illness, disease or injury.
• Potential costs of adhering to medical advice

  • Side effects
  • Financial barriers
  • Patient-practitioner relationship
• Side effects

  • Medications causing dizziness or affecting appetite
  • Risk of injury from exercise
• Financial barriers

  Some people do not adhere simply because they cannot afford it
• Patient-practitioner relationship

  The level of trust a patient has in the professional affects how likely the individual is to adhere to medical advice
• Practitioner centred approach vs a patient centred approach


  The approach taken by the practitioner can affect adherence to medical advice
• Strengths of rational non adherence

  Rational factors do influence adherence. Eg: in Spain adherence decreased for expensive drugs once individuals had to start paying for them
• Weakness of rational non adherence

  The approach assumes that the individual has logically weighed up the cost and the benefits- decisions are not typically made up this way.