Health behavior: Difference between revisions

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===Simplify medication schedules===
===Simplify medication schedules===
Medications that are taken less often per day may be easier to comply with.<ref name="pmid16270428">{{cite journal |author=Treharne GJ, Lyons AC, Kitas GD |title=Adherence to medication |journal=N. Engl. J. Med. |volume=353 |issue=18 |pages=1972-4; author reply 1972-4 |year=2005 |pmid=16270428 |doi=}}</ref> Similarly, [[polypharmacy]] should be avoided.
Medications that are taken less often per day may be easier to comply with.<ref name="pmid16270428">{{cite journal |author=Treharne GJ, Lyons AC, Kitas GD |title=Adherence to medication |journal=N. Engl. J. Med. |volume=353 |issue=18 |pages=1972-4; author reply 1972-4 |year=2005 |pmid=16270428 |doi=}}</ref> Fixed-dose combination drugs can help.<ref name="pmid18288541">{{cite journal |author=Pan F, Chernew ME, Fendrick AM |title=Impact of fixed-dose combination drugs on adherence to prescription medications |journal=J Gen Intern Med |volume=23 |issue=5 |pages=611–4 |year=2008 |month=May |pmid=18288541 |doi=10.1007/s11606-008-0544-x |url=http://dx.doi.org/10.1007/s11606-008-0544-x |issn=}}</ref><ref name="pmid17563050">{{cite journal |author=Gerbino PP, Shoheiber O |title=Adherence patterns among patients treated with fixed-dose combination versus separate antihypertensive agents |journal=Am J Health Syst Pharm |volume=64 |issue=12 |pages=1279–83 |year=2007 |month=June |pmid=17563050 |doi=10.2146/ajhp060434 |url=http://www.ajhp.org/cgi/pmidlookup?view=long&pmid=17563050 |issn=}}</ref> Similarly, [[polypharmacy]] should be avoided.


===Shared decision making===
===Shared decision making===

Revision as of 08:06, 2 May 2008

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Health behavior is defined as "behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural."[1] Health behavior includes the concept of patient compliance, which is defined as "voluntary cooperation of the patient in following a prescribed regimen."[1]

How to detect noncompliance

A systematic review by the Rational Clinical Examination concluded that missing appointment, not improving with treatment, and counting pills are the best methods to detect non-compliance.[2]

Methods to improve health behavior

Access to medical record

A randomized controlled trial found that a 20-minute sessions before regularly scheduled visits in which "patients were helped to read their medical record and coached to ask questions and negotiate medical decisions" improved functional status.[3]

Ongoing feedback

A randomized controlled trial of patients at very high risk of coronary events found that use of two clinical prediction rules (http://www.chiprehab.com/CVD/) for predicting coronary events along with tailored feedback, may improve cholesterol values.[4] In this trial, patients were also shown how their calculated risk changed over time and improved in response to changes in the patients' lifestyle changes and pharmacotherapy.

In the treatment of obesity, daily weighing is associated with better dietary restraint.[5][6]

Simplify medication schedules

Medications that are taken less often per day may be easier to comply with.[7] Fixed-dose combination drugs can help.[8][9] Similarly, polypharmacy should be avoided.

Shared decision making

For more information, see: Shared decision making.


References

  1. 1.0 1.1 National Library of Medicine. Health behavior. Retrieved on 2007-12-06. Cite error: Invalid <ref> tag; name "title" defined multiple times with different content
  2. Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G (1993). "The rational clinical examination. Is this patient taking the treatment as prescribed?". JAMA 269 (21): 2779–81. PMID 8492406[e] pdf
  3. Greenfield S, Kaplan S, Ware JE (1985). "Expanding patient involvement in care. Effects on patient outcomes". Ann. Intern. Med. 102 (4): 520–8. PMID 3977198[e]
  4. Steven A. Grover et al., “Patient Knowledge of Coronary Risk Profile Improves the Effectiveness of Dyslipidemia Therapy: The CHECK-UP Study: A Randomized Controlled Trial,” Arch Intern Med 167, no. 21 (November 26, 2007), http://archinte.ama-assn.org/cgi/content/abstract/167/21/2296 (accessed November 27, 2007).
  5. Wing RR, Tate DF, Gorin AA, Raynor HA, Fava JL (2006). "A self-regulation program for maintenance of weight loss". N. Engl. J. Med. 355 (15): 1563–71. DOI:10.1056/NEJMoa061883. PMID 17035649. Research Blogging.
  6. Wing RR, Tate DF, Gorin AA, Raynor HA, Fava JL, Machan J (2007). "STOP regain: are there negative effects of daily weighing?". J Consult Clin Psychol 75 (4): 652–6. DOI:10.1037/0022-006X.75.4.652. PMID 17663619. Research Blogging.
  7. Treharne GJ, Lyons AC, Kitas GD (2005). "Adherence to medication". N. Engl. J. Med. 353 (18): 1972-4; author reply 1972-4. PMID 16270428[e]
  8. Pan F, Chernew ME, Fendrick AM (May 2008). "Impact of fixed-dose combination drugs on adherence to prescription medications". J Gen Intern Med 23 (5): 611–4. DOI:10.1007/s11606-008-0544-x. PMID 18288541. Research Blogging.
  9. Gerbino PP, Shoheiber O (June 2007). "Adherence patterns among patients treated with fixed-dose combination versus separate antihypertensive agents". Am J Health Syst Pharm 64 (12): 1279–83. DOI:10.2146/ajhp060434. PMID 17563050. Research Blogging.

See also