Adherence. David Greene, Ph.D., O.T.R., M.O.U.S.E. Kaitlin Gibson, MS, OTR

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1 Adherence David Greene, Ph.D., O.T.R., M.O.U.S.E. Kaitlin Gibson, MS, OTR

2 Adherence Definition Adherence can mean: Adherence (medicine), the obedience of the patient to the medical advice. Adhesion Religious adherence Related: Adhesion (medicine), abnormal bands of tissue that grow in the human body

3 Compliance Definition Compliance can mean: In mechanical science, the inverse of stiffness a patient's (or doctor's) adherence to a recommended course of treatment the tendency of a hollow organ to resist recoil toward its original dimensions adherence to standards, regulations, and other requirements responding favorably to a request offered by others

4 Radomski defines adherence : Adherence has been defined as the degree to which patients and research participants act in accord with the advice of their clinician or researcher (Moseley, 2006, p. 662). Moseley, G. L. (2006).Do training diaries affect and reflect adherence to home programs? Arthritis and Rheumatism, 55, doi: /art.22086

5 Despite the evidence that people with chronic health conditions may not adhere to their health care providers recommendations, the issue of non- adherence remains largely ignored by occupational therapy clinicians and researchers. The term itself is omitted from the profession s official vocabulary (American Occupational Therapy Association [AOTA], 2008)... Mary Vining Radomski, PhD, OTR/L, FAOTA, is Clinical Scientist, Sister Kenny Research Center, 800 East 28th Street, Minneapolis, MN 55407; Mary.Radomski@allina.com AJOT, July/August 2011, Volume 65, Number 4

7 Am J Occup Ther May : ; doi: /ajot to correlate significantly with adherence to treatment. GAF, however, is...the information on medication adherence was retrieved from the patients...education, medication type, and adherence to medication were considered independent... (re: Mental Health)

10 Examples of Non-Adherence / Non-Compliance

11 Recommended Modifications: Adherence 1 Year After : Cumming et al. AJOT November/December 2001, Volume 55, Number 6

12 The only significant predictors of adherence were a belief that home modifications can prevent falls and having help at home from relatives.

13 Fall Prevention Pilot: Greene, Sample & Fruhauf

19 This was a story of??

20 FORCED ADHERENCE!

21 Now, stories of reasons for adherence:

22 Adherence: Gibson, Greene, Sample, & Cabrera

25 Cumming et al. (2001) found the only significant predictors of adherence were a belief that home modifications can prevent falls and having help at home from relatives.

26 Feinberg (1992) found that adding adherence-enhancing strategies such as using learning principles and shared expectation was linked with greater use of resting hand splints than was standard care.

27 Hammond and Freeman (2004) also demonstrated that the nature of client education for joint protection made a difference in terms of adherence at 4-yr follow-up. The people with rheumatoid arthritis who were randomly assigned to the behavioral approach (practicing strategies, goal setting, planning home programs) had significantly better joint protection adherence, less morning stiffness, and higher activities of daily living (ADL) scores than those who received standard care.

29 Understand & believe in Capable of through practice

30 Understand & believe in Capable of through practice

31 Understand & believe in Capable of through practice

32 Understand & believe in Capable of through practice

GUIDELINES FOR SUPERVISION, ROLES, AND RESPONSIBILITIES DURING THE DELIVERY OF OCCUPATIONAL THERAPY SERVICES

GUIDELINES FOR SUPERVISION, ROLES, AND RESPONSIBILITIES DURING THE DELIVERY OF OCCUPATIONAL THERAPY SERVICES This document contains four sections that direct the delivery of occupational therapy services.