Thursday, September 26, 2002: 2:45 PM-4:15 PM | |||
Predictors of Adherence in Chronic Disease | |||
| SYMPOSIUM OVERVIEW: Poor adherence is a problem that pervades the management of chronic disorders. The estimations are that as many as 20% of persons will decline treatment and of the remaining who initiate treatment, 50% will be adhering at levels insufficient to obtain treatment benefit. Poor adherence results in excess complications, disease progression, unnecessary hospitalizations, even death. Further the costs of this problem exceed $100 billion per year. The problem of poor adherence is complicated by the multiple errors that may be made in the conduct of the regimen, such as timing, omissions, and excesses. Nursing, which focuses on management of disorders through education, counseling regarding health management, discharge planning, and other activities, is key to the successful management of treatment regimen by the patient. Yet there is limited evidence in the field for successful strategies to improve adherence. Indeed the rates of poor adherence are comparable to what they were over 25 years ago. There is a need to design and evaluate intervention programs to improve adherence to chronic disease regimen. To do so requires knowledge of those factors which may influence adherence. This symposium will examine predictors of adherence to both medication and exercise regimen using newer assessment technologies and/or potential predictors which have not been thoroughly examined. Six papers will be presented within this symposium. The papers address three disease states, Rheumatoid Arthritis, Diabetes, and Urinary incontinence, each of which represent symptomatic chronic disorders. Dunbar-Jacob, et al, will address gender differences in adherence. Previous work in this area has shown varying results with studies reliant upon self-reported adherence. This paper will examine gender differences using electronic monitoring of adherence in a population who have been on treatment for RA for a period of more than 2 years. Sereika, et al, will examine the role of regimen complexity in adherence to treatment for diabetes with attention to the adolescent population. Stilley, et al, will examine cognitive and personality factors in medication adherence among a population of persons with RA. Caruthers, et al, will examine self-reported memory failures among persons with RA. Schlenk, et al, will examine memory related issues in exercise adherence among persons with RA. And Engberg, et al, will examine multiple predictors of adherence to pelvic floor exercise programs among older adults with urinary incontinence. Each of these presentations will address the issues of measurement in the examination of predictors of adherence as well as the implications of the findings for the design of nursing interventions. | |||
| Organizer: | Jacqueline Dunbar-Jacob, RN, PhD, professor and dean | ||
| Are there Gender Differences in Medication Adherence? Jacqueline Dunbar-Jacob, RN, PhD, professor and dean | |||
| Predictors of Adherence to a Pelvic Floor Muscle Exercise Regimen Sandy Engberg, RN, PhD, CRNP, Susan Sereika, PhD, associate professor, B.J. McDowell, RN, PhD, CRNP, FAAN | |||
| Predictors of Exercise in Rheumatoid Arthritis Elizabeth A. Schlenk, Mary Chester Wasko, MD, Susan Sereika, PhD, associate professor, Jacqueline Dunbar-Jacob, RN, PhD, professor and dean, C. Kent Kwoh, MD, Terence W. Starz, MD | |||
| Psychological and Cognitive Function: Predictors of Adherence with Cholesterol Lowering Treatment Carol Stilley, Christopher M. Ryan, PhD, Jacqueline Dunbar-Jacob, RN, PhD, professor and dean, Susan Sereika, PhD, associate professor, Matthew Muldoon, MD | |||
| The Relationship of Intensive Insulin Therapy Use, Stress, Adherence and Health in Female Adolescents with Type I Diabetes Susan Sereika, PhD, associate professor, Denise Charron-Prochownik, RN, PhD, CRNP, assistant professor, Dorothy Becker, MD, director, Division of Pediatric Endocrinology, Meg Ferons, RN, MSN, CRNP, graduate student researcher/PhD student, Jamie Reddinger, RN, BSN, graduate student researcher/Master's NP student | |||
| The Relationship of Self-Reported Everyday Memory and Low Rates of Medication Adherence Donna Caruthers, Jacqueline Dunbar-Jacob, RN, PhD, professor and dean, Susan Sereika, PhD, associate professor | |||
The Advancing Nursing Practice Excellence: State of the Science