Adherence to Antibiotic Therapy in Primary Care

Grand Canyon University

Introduction To Nursing Research

Terese Verklan

July 6th, 2014 Adherence to Antibiotic Therapy in Primary Care
Problem Statement “The term compliance or adherence can be described as the extent or correlation between the patient’s obedience to the therapy and the advice of health providers. Thus, it is related to the patient’s drug-taking attitude. Even when appropriate treatment is prescribed successful results may not always be achieved if patient’s use their medicines improperly” (Göktay, Telefoncu, Kadıoƃlu, Macit, Şencan, & Clark, 2013, p. 113). Many uncomplicated bacterial illnesses react quickly after starting treatment with antibiotics. This can lead to people failing to complete the entire course of treatment and thus recurrence of the illness. In some diseases, it takes a certain length of time of exposure to a specific dose of an antibiotic to kill the bacteria. If the right dose is not taken for the correct length of time, some of the bacteria or viruses may survive, multiply, and cause the infection to recur. “Adherence is an important factor in the achievement of therapeutic outcomes, while patient education is thought to positively affect adherence. The aim of this study is to assess patient adherence to prescribed antibacterial agents impact of patient education on adherence with the therapy” (Göktay, Telefoncu, Kadıoƃlu, Macit, Şencan, & Clark, 2013, p. 113).
Purpose and Research Questions “This study was a prospective, controlled trial and conduced in a community pharmacy. Consecutive patients that had been prescribed oral antibiotic therapy for any type of infectious diseases were asked to participate in the trial. A total of 60 patient’s were included in the study” (Göktay, Telefoncu, Kadıoƃlu, Macit, Şencan, & Clark, 2013, p. 113). It is a nurse’s role before discharge to explain the importance of adhering to the exact medication regimen prescribed. According to the article Combining Qualitative and Quantitative Methods in Information Systems Research, “ Qualitative strategies emphasize an interpretive approach that uses data to both pose and resolve research questions. Researchers develop categories and meanings from the data through an iterative process that starts by developing a initial understand of the perspective of those being studies” (Kaplan, & Duchon, 1988, p. 573). The study states that, “After filling out an initial questionnaire, patient’s were educated about their antibiotic therapy either in a simple or more comprehensive way. A second questionnaire, conducted the day after antibiotic therapy ended, focused on how patients had actually used their antibiotics and based on patients’ self reports. Adherence was assessed using both a tablet count and a self-report method to explore whether the timing of the doses was correct” (Göktay, Telefoncu, Kadıoƃlu, Macit, Şencan, & Clark, 2013, p. 113).
Literature Review The authors included several quantitative and qualitative studies that where relevant to the studies from 1999 through 2007. These articles included Churchhills’ Clinical Pharmacy Survival Guide, Non-compliance with antibiotic therapy for acute community infections, and Promoting adherence to antibiotics a test of implementation intentions. The author talked about patient’s lack of knowledge in adhering to antibiotic treatments. It talked about the lack of knowledge that, “Antibiotics are efficient, potent safe and life saving agents used to facilitate the healing of bacterial infections. Unnecessary and/or inappropriate usage of these drugs is a common cause of the development and spread of resistance to them” (Göktay, Telefoncu, Kadıoƃlu, Macit, Şencan, & Clark, 2013, p. 114).
Conceptual/Theoretical Framework This study was performed using a phenomenological data analysis. “Patient’s were informed about the study orally in the first instance. The patient’s answered the first questionnaire, which was administered by the pharmacist. In this questionnaire the data of the socio-demographic characteristics of patient, the health center/organization and specialty of prescribing physician, diagnosis and prescribed drugs, whether or not the physician aked the patient if he/she had a chronic disease requiring medication, apart from the prescribed antibacterial and adjuvant drugs. The day after the end of the antibacterial treatment, patients were contacted by phone and asked to help complete a second questionnaire. In this questionnaire, the number of remaining pills in the blister or box, whether the patient omitted to take his/her medication or deliberately missed a dose, how many pills the patient took per day and at what time, regularly or irregularly and whether the patient felt much better or not after the antibiotic therapy” (Göktay, Telefoncu, Kadıoƃlu, Macit, Şencan, & Clark, 2013, p. 113)
Conclusion
Patients should be made aware of the importance of following antibiotic regimes exactly. They should know that no following the prescribed regime leads to recurrence of the infection and also can lead to non-resistant bacterial organisms. The study showed that, “Pharmacists may be able to play a role in providing pharmaceutical care to patients receiving antibiotic treatments and can help to ensure patients use their medications appropriately and enhance rational antibiotic use” (Göktay, Telefoncu, Kadıoƃlu, Macit, Şencan, & Clark, 2013, p. 113). Reference:
Göktay, N., Telefoncu, S., Kadıoƃlu, S., Macit, Ç., Şencan, N., & Clark, P. (2013). The role of patient education in adherence to antibiotic therapy in primary care. Marmara Pharmaceutical Journal, 17(2), 113-119.
Kaplan, B., & Duchon, D. (1988). Combining Qualitative and Quantitative Methods in Information Systems Research: A Case Study. MIS Quarterly