Med surgical

PICOT paper

Module 7

Anita Massey

Rasmussen College

Priyal Patel

August 22, 2021

PICOT paper 2

Introduction

It is described as the extent to which a person’s behavior such as taking the medications

given, following diet and implementing lifestyle changes corresponds to the prescriptions of the

healthcare provider. Adherence to treatment varied with the age of the patient and as well as the

environment in which the individual is in. There are factors that are considered as major influence

to adherence to treatment. Among the factors include the side effects of the medication where an

individual may choose not to follow the medication as prescribed by the healthcare provider if the

side effects are intense. The second factor that affects adherence to treatment is cost of the

medication where higher cost of medication may discourage the patient from meeting the

requirements of the prescription from the healthcare provider.

Also, dosing frequency influence the extent to which an individual follows the prescription

given by the healthcare provider on the medication. In addition to the factors that influence

adherence to medication is the routes for administration. As defined in the introduction, adherence

to treatment may occur in various ways including medication, lifestyle changes or diet changes. An

individual may present different levels of correspondence depending with the area. For instance,

executing lifestyle changes may have lower level of adherence compared to taking medications of

following diet. In addition to the factors that may influence adherence to treatment include the

patient demographics, beliefs and comorbidities. Among the demographics considered is age such

as adherence to treatment among the adults (Raynor, 2020).

Reason for choosing the topic

I chose because I had one family member suffer in past with tuberculosis. Adherence to

treatment has been selected for the discussion as it is plays a significant role in patient outcome and

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general well-being of an individual recovering from an ailment. Determining the impact of one of

the factors outlined which influence adherence to treatment provides a thorough understanding of

what interventions needs to be done to reduce the prevalence of low adherence to treatment.

PICOT Question: In tuberculosis grown-up patients, how does adherence to treatment

contrasted and a non-adherence influence

In tuberculosis grown-up patients, the level of adherence to treatment varies with certain

elements or basis. The basis determines the difference in the adherence to treatment on various

conditions. One of the bases used is the nature of work schedules particularly given that majority

of the adults are either employed or working in their own businesses that vary with the level of

time commitment to the job. Tight work schedules affect adherence to treatment where patients

with tight work schedules realize more difficult in following the medication as prescribed by the

healthcare provider. Less tight work schedules offer opportunity for the patient to follow the

medications or treatment procedure as prescribed. The higher the commitment to other activities,

the higher the chances of the patient failing to adhere to the treatment plan (Wahyuni et al, 2018).

The second basis of contrast in adherence to treatment is social norms. Different people

have different sets of belief that influence their decisions on medication. Some of the social norms

that impact the behavior of individuals determine the level of adherence. For instance, some

patients have strong belief on the effectiveness of herbal medications compared to the artificial

drugs. This affects the adherence to medications in that they are less-inclined to artificial

medication. This lowers adherence to treatment if the treatment plan was given by a healthcare

provider. Similarly, an individual with positive attitude towards modern science and medication

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has a higher adherence to treatment compared to those who believe more on traditional medication

(Raynor, 2020).

The third basis of contract in adherence to medication among tuberculosis grown-up

patients is the quality of prescription instructions. Tuberculosis requires the patient to continue

taking medications over long period of time. This requires strict follow-up of the treatment plan to

ensure the medication or diet prescribed is followed. Therefore, the prescription instructions play a

significant role in the patient outcome. Poor prescription instructions lowers adherence to treatment

where the instructions are given by the healthcare provider without consideration of the

characteristics of the patient. Well-developed prescription instructions where the guidelines match

the social status of the patient such as progressive change of lifestyle contributes more to

effectiveness of treatment to improved patient outcome. The fourth basis of contrast in adherence

to treatment is experience to medication where patients have varied experience in using long-term

medications. The higher the experience in following treatment plan, the higher the adherence to

medication. Lower experiences expose the patient to errors in follow-ups on the treatment plan and

medications (Wahyuni et al, 2018).

Non-adherence to treatment among grown-up tuberculosis patients is dependent on certain

factors. Among the factors include poor prescription, lack of knowledge on medication and very

tight work schedules. The outlined factors discourage the patient from adhering to the prescribed

instructions. This occurs through either failing to understand the treatment plan or inappropriate

treatment plan based on the demographics of the patient (Guix-Comellas et al, 2017).

Methods used in evaluating effectiveness of implementation

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Effectiveness of implementation can be assessed by determining the expected outcomes of

the conditions and whether the intended goal was attained. In goal-based approach, the healthcare

provider use patient outcome measures to determine the level of adherence to treatment among

tuberculosis patients. Among the measures include readmission to healthcare facilities, patient

experience and effectiveness of care. Goal-based approach is based on the goals set on the

treatment plan where the patient is monitored to determine whether the objectives and goals of the

treatment plan were attained (Liu et al, 2020).

Reference

Guix-Comellas, E. M., Rozas-Quesada, L., Morín-Fraile, V., Estrada-Masllorens, J. M., Galimany-

Masclans, J., Sancho-Agredano, R., ... & Noguera-Julian, A. (2017). Educational measure

for promoting adherence to treatment for tuberculosis. Procedia-Social and Behavioral

Sciences, 237, 705-709.

Liu, B., Xue, B., Meng, J., Chen, X., & Sun, T. (2020). How project management practices lead to

infrastructure sustainable success: an empirical study based on goal-setting

theory. Engineering, Construction and Architectural Management.

Raynor, D. K. (2020). The influence of written information on patient knowledge and adherence to

treatment. In Adherence to treatment in medical conditions (pp. 83-111). CRC Press.

Wahyuni, A. S., Soeroso, N. N., Wahyuni, D. D., Amelia, R. I. N. A., & Alona, I. V. A. N. A.

(2018). Relationship of attitudes and perceptions with adherence in treatment of pulmonary

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tuberculosis patients in Medan, Indonesia. Asian Journal of Pharmaceutical and Clinical

Research, 11, 222-224.

Batten, D., Schummer, P., & Selden, H. (Eds.). (2017). Human Diseases and Conditions (3rd ed., Vol. 3). Charles Scribner's Sons. https://link.gale.com/apps/pub/8TZH/GVRL? u=mnarasmuss&sid=bookmark-GVRL

Longe, J. L. (Ed.). (2021). The Gale Encyclopedia of Children's Health: Infancy through Adolescence (4th ed., Vol. 6). Gale. https://link.gale.com/apps/pub/850V/GVRL?u=mnarasmuss&sid=bookmark- GVRL

Pan, S.-W., Su, W.-J., Chan, Y.-J., Chuang, F.-Y., Feng, J.-Y., & Chen, Y.-M. (2021). Mycobacterium tuberculosis–derived circulating cell-free DNA in patients with pulmonary tuberculosis and persons with latent tuberculosis infection. PLoS ONE, 16(6), 1–12. https://doi.org/10.1371/journal.pone.0253879