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CHAPTER 9: TRUCKING ALONG: MEDICATION ADHERENCE WITH PROVIDER ISSUES

Which of the following is the most common misconception about medication adherence?

A. It is the provider’s role to primarily manage a patient’s chronic disease state

B. Patients must have a sufficient understanding of the regimen

C. Cultural factors may contribute to nonadherence

D. Adherence can be assessed by both subjective and objective means

Correct answer: A

Rationale: Answers B, C, and D are correct statements. However, it is a common misconception that clinicians manage the patient’s chronic disease state (answer A). In fact, providers only manage the condition during brief follow-up appointments, and patients manage the condition at all other times.1

The term “adherence” refers to:

A. The number of pills picked up from the pharmacy, and is economically focused

B. The shared decision-making between the provider and the patient

C. Passive behavior in which the patient is following instructions from the provider

D. Active, voluntary, and collaborative involvement in a mutually accepted therapeutic course

Correct answer: D

Rationale: The correct answer is D, which is a widely accepted definition of “adherence.”2 Answer A refers to “persistence” and is not routinely utilized terminology. Answer B refers to “concordance,” which is a clinically accepted medical term addressing the shared decision-making process. Answer C is incorrect because adherence indicates a patient is actively involved in their care. The term “compliance” is still commonly used, however, because this term is often inappropriately used interchangeably with “adherence.” The term “compliance” has been considered politically incorrect by some because it may imply that the patient should “follow the provider’s orders.”1

What primary type of nonadherence is JW demonstrating?

A. Capricious nonadherence

B. Intelligent nonadherence

C. Unintentional nonadherence

D. Unintelligent nonadherence

Correct answer: B

Rationale: JW is aware of why he is not taking his medications, so he is demonstrating intelligent nonadherence and B is correct. However, he is not obstinately avoiding his medication, therefore A is incorrect. The patient does not have a condition that causes him to forget his medications, therefore C is incorrect. There is no such thing as unintelligent nonadherence, hence D is incorrect.1

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