Summary Cystic fibrosis [CF] is a chronic disease in which preventative treatment with nebulised antibiotics can reduce pulmonary exacerbations that otherwise require rescue therapy. However, adherence is low. Making adherence to maintenance treatment visible is a crucial step towards improving adherence. In this article, we discuss how adherence data can be used to support Quality Improvement in CF through behaviour change in both people with cystic fibrosis and their clinical teams. Keywords: Adherence, Cystic Fibrosis, Telemedicine The problem with treatment adherence in long-term conditions Adherence to medication among patients with long-term conditions is a major problem. An estimated 30-50% of medicines are not taken as recommended and adherence tends to decline after the first 6 months of treatment.[1, 2] Within the NHS, medication spend (£13-£14 billion per year) is the second highest cost after staff, yet it is estimated that within primary care at least £300 million worth of medicines are wasted each year due to poor adherence.[1] Other societal and economic costs of poor adherence include preventable hospital admissions, morbidity and mortality.[1] As the NHS faces increasing pressures from an ageing population, rising expectations and expensive technology, optimising medication use is an important agenda if NHS England is to improve population health and keep healthcare affordable.[3] Non-adherence is often discussed by healthcare professionals as an incomprehensible problem that only afflicts badly-behaved patients. In fact non-adherence affects us all: 80% of New Year’s resolutions fail,[4] not all members of the CF MDT take 30 minutes of exercise each day, eat 5-a-day and keep their BMI’s below 25. The insight that... ... middle of paper ... ...ven the smallest units to be understood which could never occur with outcomes such as BMI or FEV1.[10] Conclusion The CF community is a cohesive group of clinicians looking after a relatively small population within specialist clinics in which technology can be introduced across the whole population in a way that can be used to transform clinical practice. Improving adherence in CF offers the possibility of transforming CF care from unscheduled hospital based rescue that is disruptive to employment and schooling to scheduled, strategic and efficient community based prevention tailored to individuals’ needs. This will require optimal use of preventative therapy achieved by making adherence measures clearly visible within routine clinical practice combined with appropriate behaviour change strategies for clinicians and PWCF that can support ongoing quality improvement.
The rise in demand is in part due to an aging population and is reinforced by the prevalence of long-term health conditions. The high cost of treatments is derived from advances in medical science whereby expensive sophisticated techniques are available and specialist medications are employed to control or cure conditions. The poor services offered by the NHS has caused a fall ...
CF is a chronic condition therefore the patients are either seeking medical attention or receiving (sometime involuntarily) a great deal of medical scrutiny and intervention during their lifetime.
Along with the problems of chronic illnesses themselves, many other problems may come. Treatments and medications are just the beginning of things when it comes to problems with illnesses. With cystic fibrosis, you start out with a high number of medications and treatments to begin with. The older you get and the worse your condition gets, the more you take. (“Psychological impact,” n.d.) Many struggles come along with taking these medications and treatments. When children are first diagnosed with cystic fibrosis, they are typically very young. From the beginning, there are many medications and treatments that needed to be taken and done. Sometimes, trying to get children to take medications and treatments is like pulling teeth. The medications for cystic fibrosis are extremely important. If cystic fibrosis patients miss medica...
Chronic diseases, unlike acute illnesses that are episodic and treatable with the hope of returning to normalcy, are a continuing multivariate process necessitating persistent management . In addition, the management is not limited only to care but to enable the p...
The more an individual frequently engages in positive or negative behavior, the greater the incidence of permanent change. If the behavior is positive and incorporated into everyday life, the result is “improved overall health, enhanced functional ability, and a better quality of life at all stages of development” for the patient (Pender, 2002). Competing demands such as children, employment, and prior obligations may interfere with an individual’s commitment to action. This can directly affect the outcome of participation and commitment in health behavior, but Pender noted that there is limited significance on its effects in comparison to all other
Youth with CF also deal with more health risk behavior. These risk factors include smoking daily, using cannabis, and performing antisocial or violent acts. These risk factors usually come in clusters and increase in age. Many factors contribute to this behavior like age, gender, academic track, and parents' education level, all differences except alcohol misuse remained significant. People with CF more likely to be depressed, and more likely to rate their health as poor. The climate can also put a person with CF under more stress if ...
According to the American College of Preventative Medicine (2011), non-adherence to medications is estimated to cause 125,000 deaths annually and overall, about 20% to 50% of patients are non-adherent to medical therapy. Through my personal experience working in the healthcare field, I have observed an increasing number of patients seemingly detached from the seriousness of their medical diagnoses, as the majority of my patients have taken very little personal responsibility in their own healing and overall health. While these patients have a variety of medical issues, they do share similar characteristics: disengagement from their medical diagnoses and taking the necessary steps towards healing, health and vitality. In my work or in my clinical experiences, I get frustrated when patients are
Cystic fibrosis, also known as CF, affects over 30,000 children and adults world-wide. CF is a disease in the lungs and digestive system and is still incurable today. It is a disease that causes thick, abnormal mucus in the lungs, nasal polyps, fatigue, and can also damage organs in a person’s body. According to www.cff.org/aboutcf, over 70% of CF patients are diagnosed at two years of age. Cystic fibrosis is one of the most life-threatening diseases in the United States and is very common amongst chronic diseases. Cystic fibrosis is most commonly diagnosed in young children and sometimes adults.
Kuther, N. (2001). Improving compliance in dialysis patients: Does anything work. Seminars in Dialysis, 14(5), 324-327.
One way to decrease the prevalence of deteriorating health for any population is by using preventive care measures (Andrews, & Boyle, 2008). The use of preventive care allows significant problems to be identified early which enables the resolution of the problem when it is still a minor issue (U.S. Department of Health and Human Services, 2008). Often this strategy is more cost effective and require...
Iglehart, J.K (1999). The American health care system--expenditures. The New England Journal of Medicine, 340(1).
This relationship can be successfully built in the presence of appropriate communication. The positive correlation has been found between the patients’ adherence and the good communication in various recent studies. It means that the effective communication can make the patients understand the details of their illness, get a knowledge about the steps to be taken in order to cure it and get motivation to keep up their morale (Bakken et al., 2000).
...are immense, as it has only finite resources to use, but needs its services to be clinically effective as well as able to meet the needs of individual’s, their choice of preferences and be value for money. To accomplish this NHS will need to harness more securely its investment in surveillance, analysis and budgets, and therefore establishing a framework that would than serve and provide a better health outcome to the entire nation. Lastly, UK spends about half of what is spent by the US (about 14 % of GDP) on its healthcare, yet in US out of 250 million over 30 million citizens are still without health care provision. Thus, despite such a massive expenditure by US government, failure to provide basic health care to millions of its citizen is not overcome, however, that is certainly not the case in UK (Bilton, et al., 2002; Christopher, 2004; Smith I. , 2007).
was well organized, efficient and effective. She was compliant with 83% of the new plan regimen by the end of the four weeks project. She was also in compliant of her weekly weight regimen and documentations throughout the course of the project. Even though C.M skipped imputing some caloric intake and meal times in her journal, at the end, she was able to achieve 90 % compliance of healthy eating through label reading food planning and the use of the national dietary guidelines. She was also able to reduce her intake of fast foods noted by a marked reduction in weight of 7 lbs. at the end of the third week. While C.M made a lot of progress in most of the itemized plan of care, she was non-compliant in the area of meeting with a nutritional counsellor. She attributed this to lack of time and financial
learned how important it is that we must help our patients make a commitment to continue to