Increasing Compliance With Asthma Patients in Pediatric Care - Research Paper Example

?INCREASING COMPLIANCE WITH ASTHMA PATIENTS IN PEDIATRIC CARE College: Compliance in healthcare refers to the extent to which a patient’s behavior coincides with medical and health advice. Compliance is also acknowledged as adherence, even though adherence is less critical and has less negative effects. The two terms have been portrayed in a paternalistic relationship than a partnership one. Compliance is useful in medical treatment. It is vital for preventing diseases, promoting health along with successful treatment. Agreement to follow prescription depends on the ability of a pediatric patient and the physician to commit to these objectives (Murphy et al 2009). Meagre compliance puts pediatric patients in danger of more medical problem of continued disease. Non-compliance leads to difficulties in assessment of children’s condition. This is a cause for poor diagnosis and lowered quality of healthcare on the patient. Non-compliance causes the relationship between a patient and doctor to be complicated. For compliance to hold, it is important for the doctor to have a one on one relationship with the patient. Nearly a third of pediatric patients fail to comply with treatment in the short term. Non-compliance is not necessary dangerous or inappropriate in cases where patients fail to comply from fear of harm by the medication prescribed from their past experience and in cases where it is ‘intelligent non-compliance.’ Non-compliance takes various forms such as, failure to attend appointments, missing doses of medication. Patients may fail to make appropriate use of their inhaling device. Using an inhaling device wrongly could be intended or a mistake of competence on the patient’s part. Pediatric physicians are encouraged to ensure children patients are well advised on use of inhaling devices whether their parents or those in charge of them are available or not for the sake of emergencies. Compliance in pediatric patients is determined by certain factors such as the patient’s health literacy and their believe systems along with patient’s general education. Patient’s decision to comply is dependent on other factors such as side effects of medication on the patient. Pediatric readmissions are at times consequences of wrong or inadequate instructions on medication by the physician giving prescriptions. Non-compliance leads to further complications that cause patients to spend more time and money in the process of treatment. Approximately $8.5 billion is spent unnecessarily each year on treatments related to non-compliance to medication. Such treatments involve both medical visits and hospitalization other than the initial treatment. This data by the National Pharmaceutical Council implies that most caregivers or parents in charge of a child’s medical prescription fail to insist on the importance of adherence to the prescriptions provided. Parents and caregivers are encouraged to seek assistance from physicians in case of emergencies whenever they can. They are advised on good knowledge of handling techniques for asthma in most situations. The Joint Commission in 2008, allowed and encouraged children hospitals to base compliance reports of core values as Children Asthma Care three. These values are easy to `adopt for hospitals and are efficient in encouraging adherence to medication. Compliance to CAC-1 and two has been on a high note while compliance to CAC-3 has yielded little (Krasnegor 2011). . In bid to reduce the number of asthma pediatric patients re admitted to hospital, organizations have created home based management plans to aid in prescription adherence. The home management plan enhances the patient’s compliance after discharge. These initiatives require hospitals to commit to the process of creating adherence by developing an asthma-specific program. This program, “reminder and decision support” facilitates discharge of patients while availing administrative and clinical needs at home and school. Reminder and Decision Support gives advice on preventive measures on asthma and compliance to those measures. It creates instructions for the patient to use after discharge and ensures they are well understood. The RADS provides necessary recording for good accreditation on home based management plans. It provides with a summary of after discharge mechanism to enable a follow up process that ensures adherence was actually observed before other treatment can be made on patients. The monitoring process uses electronic methods as well as patient’s diary cards and questionnaires filled in by caregivers and patients for data. Electronic Monitoring Devices are especially reliable for making the most accurate data on compliance. EMDs have been used as a standard method compared to questioning and observations that may be lengthy and time consuming. Obtaining such data within short periods of time enhances creation of methods by pediatric practitioners to address non-compliance and saves lives. It also enhances use of preventive measures against asthma in children to prevent complications in the treatment process and re admission. The consequences of non-compliance in parents for children are such as failure in children’s outpatient treatment for patients of asthma. They pose as challenges for parents in their financial capacities as well as time and commitment. Lack of compliance could lead to spending unnecessarily large amounts of money and time that could be saved by following prescription. These are caused by sub-therapeutic levels of theophylline. Sub therapeutic theophylline levels are as especially common in children with acute asthma and asthmatic periods. Sub therapeutic theophylline levels could be as less as 10mcg/ml. in dealing with non-compliance, it is necessary to address preventive medication for asthmatic patients. Preventive medication has been proved to reduce inflammation in the lungs and improve on the general outcome of the disease in asthmatic patients. It is important in cases where children have a persistent case of asthma. Compliance to preventive medication is a great contributor in reducing the asthma related mortality rate in children between the ages of 6-12. Impact of non-compliance is determined by the severity of the asthmatic condition in question and patient’s responsiveness to medication Acute asthmatic attacks if not well addressed through management of the disease and preventive medication is likely to lead to death (Turner et al 2008). Adherence is emphasized on those patients with more persistent symptoms. It reduces with age as the children growing with asthma are left to independence and personal responsibility during growth. Parents and caregivers are encouraged to emphasize medication and measures of managing the disease upon their children and monitoring them more as they grow to increase compliance (Drabman et al 2009). Even when reminders may be annoying to adolescents, it is important for parents to insist to their young ones on medication as sensitive as asthmatic prescription. They should create a relationship between themselves and their children’s asthma condition to observe them for good watch on compliance. Children whose parents suffer poor mental health or other condition have been noted to have a poor adherence to asthma medication and overall management. It is advisable that other responsible parties chip in the duty or physicians advise on a hired personal caretaker for the child. The children themselves may be challenged with behavior difficulties that include; withdrawal, somatic response or aggression and defiant behavior. The question of gender is however not a factor in addressing non-compliance amongst children (Drabman 2009). According to Health’s behavior Model the attitude of patients toward adherence is based on an analysis by those patients of treatment that revolve around financial costs and effects of the medication. The Ecological Model explains adherence as affected by factors of surrounding such as culture and conflict. These are based on health as a priority with regard to personal lifestyle of the patient. The Ecological Model involves stressors as a factor of attitude toward medication along with other separate factors as skill and personal beliefs of people and their developments, for example children’s education on causality (Gross et al 2009). General conclusions have it that people make most of their decisions based on emotion at the point in time and the situations surrounding them than actual medical reason. Such models are useful in creating strategies to deal with non-adherence by enhancing study of concepts of structure that non-adherence results from. Increasing compliance rates in patients of asthma is useful for both good health in everyday life that gives quality afterward to the overall life of a person. Adherence is affected by social economic factors that are in most cases possible to control. When compliance may not be the major cause of survival or saving lives among children with asthma, it contributes a great deal in sustenance and reducing risk of death. In general it makes the life of the patient more efficient and the overall effect is evident (Drotar 2009). Compliance reduces the risks and rate of mortality amongst children that are apparent in the society. Non-compliance is a behavior to be addressed in pediatric practice among children with poorly controlled asthma. It is the duty of the responsible parties and the entire society for these children patients to take action on situations that the children may not be in a position to handle. For example, asthmatic children that come from financially challenged families and where the parents are not in a position to take care of them should be aided with public information on controlling asthma and obtaining medical care. Governments should be involved in awareness processes as this in conjunction with health facilities and initiatives. Oppression of children with asthma in schools and families is also an issue to reckon with when it comes to dealing with asthma and compliance. Bibliography Drotar, D. (2009). Promoting adherence to medical treatment in chronic childhood illness: Concepts, methods, and interventions. Mahwah, N.J: L. Erlbaum Associates. Gross, A. M., & Drabman, R. S. (2009). Handbook of clinical behavioral pediatrics. New York: Plenum Press. Krasnegor, N. A. (2011). Developmental aspects of health compliance behavior. Hillsdale, N.J: L. Erlbaum Associates. Murphy, S., & Kelly, H. W. (2009). Pediatric asthma. New York: M. Dekker. Turner, J., McDonald, G. J., & Larter, N. L. (2008). Handbook of adult & pediatric respiratory home care. St. Louis: Mosby. Read More