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file:///C:/E513C9E9/adherence01(london)_files/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C414CB.6900E740 Content-Location: file:///C:/E513C9E9/adherence01(london)_files/slide0024.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" compliance in adolescence (Sydney 97)
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  TRIEMLI - ZÜRICH
I FEEL GREAT !
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owh= y taking my pills?
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  TRIEMLI - ZÜRICH
ADHERE= NCE IN CHRONIC DISEASE
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o <= /nobr>
o
Ueli Bühlman= n, M.D.
Dept. of Pediatri= cs and Adolescent Medicine
Triemli Medical C= enter, Zürich/Switzerland
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE INTROD= UCTION
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o&#= 13;
o&#= 8220;Once upon a time ...
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o..= . there was my grand-aunt.”
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
INTRODUCTION
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oThis presentation has= to do:
o ... with what patients believe, an= d
o ... with what doctors believe, and=
o ... how these beliefs can come tog= ether, <= span lang=3DEN-US style=3D'font-size:113%;color:white'> and hopefully lead to better adherence
o
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
DEFINITIONS
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oCO= MPLIANCE OR ADHERENCE  ...
o
o..= . that is the question!
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  TRIEMLI - ZÜRICH
ADHERE= NCE IN CHRONIC DISEASE
DEFINITIONS (1)=
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oCo= mpliance: <= /b>
oThe property of alte= ration of the shape or size of a structure as the result of the application of a distorting force; i.e. reduced compliance means greater stiffness.<= span lang=3DEN-US style=3D'color:white;display:none'>
oButter= sworths Medical Dictionary
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  TRIEMLI - ZÜRICH
ADHERE= NCE IN CHRONIC DISEASE
DEFINITIONS (2)=
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oCompliance: =
oA quality of yieldin= g to pressure or force without disruption ...
o
oDortla= nd's Medical Dictionary
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
DEFINITIONS (3)=
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oAdherence:
oThe act or quality of sticking to something.
o
o= The extent of accordance of patient behavior with medical regimen.<= span style=3D'color:white;mso-special-format:lastCR;display:none'> <= /div>
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
SUMMARY # 1
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oadherence is the result of a proce= ss with different involved parties
odifferent parties h= ave different views and perceptions
oadherence is never = about who is right or wrong!
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
A HISTORIC WARNING
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o&#= 8222;Keep watch also on the fault of patients which often makes them lie about t= he taking of things prescribed.“
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oHip= pokrates
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
TREATMENT GOALS=
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oWith our treatment, we want ...= 3;
o... the patient to recover from a di= sease, or
o= ... prevent something unwanted or risky, or
o= ... make the patient feel better, or
o= ... etc., etc.
oWe, the doctors, want= to help!
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
MEDICAL REGIMENS
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oexamples of “cl= assical treatments”:
<= span style=3D'color:white'>o= antibiotics in infectious diseases
= o“the pill” in contracept= ion
oinhalations in inflammatory airway d= isease such as asthma or Cystic Fibrosis (C= F)
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
ANTIBIOTICS
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oTreatment of acute otitis media (AOM)
oamoxicillin for 10 days is standard&= #13;
o= metaanalysis (1995): amoxi for 5 days only
o= Dutch study (1998): no antibiotics needed in most cases; symptomatic (antiinflamm= atory) treatment for pain and fever
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
AIRWAY DISEASE<= /div>
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o= the story of theophyllin in asthma - from highly important to highly dangerous=
o= the use of inhalators in asthma - a tool for random use? (Schöni 1991)
o= the use of inhaled steroids in CF - one of the many “non-evidence̶= 1; based treatments in a chronic disease (ESCF 2000)=
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  TRIEMLI - ZÜRICH
ADHERENCE IN CHRONIC DISEASE
SUMMARY # 2
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