Sociological Perspective For Not Adhering To The Treatment By The Patients

Sociological perspective for not adhering to the treatment by the patients

Introduction

According to World Health Organisation (WHO), treatment adherence is the extent to which a person behaves by taking medication, following healthy diet and executing physical exercise or lifestyle changes corresponding to the agreed recommendation provided by health professional (WHO, 2020). However, in many cases, it is seen that patient avoid remaining adhere to the healthcare treatment due to various social and behavioural factors. Thus, in this podcast, the reason behind the non-adherence of patients to treatment is to be explained through sociological perspective of Medicine Adherence Model and Health Belief Model. The concepts developed are to be applied to non-adherence of treatment towards major depression among individuals.

Sociological Analysis

The sociological perspective informs about the social phenomenon from different levels that influences thinking and action regarding certain activities. In explaining the reason for non-adherence of patients towards treatment, the sociological perspective presented by Medicine Adherence Model is to be focussed. The medicine adherence model (MAM) is structured with the social idea that there are two types of non-adherence which contribute towards inconsistent intake of medication in treatment which are intentional decision to avoid medication and the unintentional interruptions for not taking prescribed medication in the treatment. The three core concepts of the model are purposeful action, feedback and patterned behaviour (Jung and Tak, 2019). As per the purposeful action concept of the model, the patients initiate and sustain adherence to medication in treatment by being dependent on perceived effectiveness, need and safety regarding the medication prescribed in the treatment (Ding et al., 2018). This is because without feeling of need and effectiveness of the medication provided in treatment, the patient perceive that the medication is of no use and involve loss of money in following the treatment. Moreover, the lack of safety in medication use with increased side-effects leads the patients to feel disengaged out of frustration to adhere to the dose mentioned (Emilsson et al., 2017). In people with major depression, the common medication provided in the treatment are anti-depressants. The effect of the anti-depressants is to make the person feel relived from the symptoms of depression and avoid the symptoms to exacerbate. This effectiveness of the anti-depressants on people are considered to take minimum of 8-12 weeks for showing their entire beneficial action (Henssler et al., 2018). This leads people with major depression to non-adhere to the medication (anti-depressants) in the treatment as they do not identify its effectiveness and need at the earliest. It makes the people feel confused and frustrated as well as feel waste of time towards using the medication and adhere to the treatment (Obata, 2017). Moreover, the side-effects of anti-depressants include dizziness which makes the person with major depression feel sleepy most of the time. This makes them feel lack of safety towards using it and perceive it as a drug due to which they non-adhere to the medication dose recommended by physicians (Read and Williams, 2018). It proves the sociological perspective that lack of purposeful action affects the non-adherence to medication in treatment. The pattern behaviour concept from MMA mentions that level of access, routine and remembering to take medication are responsible to influence adherence of medication in treatment (Jung and Tak, 2019). This is evident in case of people suffering from major depression who non-adhere to the treatment by unfollowing intake of proper medication. It is proved through the study of Khalifeh and Hamdan-Mansour (2020) who informs that people with depression or other major health issues when experience long-waiting time in the clinics, lack of easy transportation in availing medication and failing to remember the medicine dose show non-adherence in treatment. The MMA concept also informs that on the basis of available information, events and prompts (feedback) regarding intervention in healthcare treatment influences hypertensive perspective of the patient to adhere to the treatment. This is because negative feedback regarding medication leads the patient feel vulnerable in following the intervention and neglect in the midway as well as stop treatment (Argent et al., 2018). This indicates that if the patients with major depression access feedback that the medication or the care services from the physicians they are availing care have negative experiences in care, they out of feeling of vulnerability would avoid and stop following or adhering to the treatment. The Health Belief Model (HBM) is referred to social psychological health behaviour change model which explain and predicts the changes in health-related actions and behaviour in regard to use of healthcare service. The key theoretical concepts of HBM are perceived susceptibility, perceived severity, perceived benefits, perceived barriers, modifying variables, cue to actions and self-efficacy (Green et al., 2020). According to HBM, people adhere to treatment when they perceive they are susceptible to any specific health issue to reduce its risky impact on their health (Wu et al., 2020). This indicates that people who has the idea that depression or other mental health issues are not going to occur to them are seen to avoid adhering to healthy diet and maintaining enhanced social life. The perceived benefits make an individual to adhere to the treatment as feel valued and perceive health efficacy to be experienced on following the intervention (Jeong and Ham, 2018). This is evident in case of people with major depression where the individuals who are educated regarding the usefulness of psychiatric intervention are seen to approve and follow the treatment. However, the people who do not considered depression to be a health issue and lack education regarding the effectiveness, as well as importance of care for depression, are seen to ignore in adhering or following the care. This leads to their increased mental suffering with deteriorated health condition (Haigh et al., 2018). The perceived severity in HBM informs that people are intended to adhere to healthcare and treatment for health issue when they feel that the specific health problem is an issue and is going to create deteriorated health impact on them both mentally and physically (Esparza-Del Villar et al., 2017). This is evident people with depression in most cases due to lack of enhanced health education are unaware of its severity and ignore to avoid adhering to care. Moreover, people think that depression only happens with age and therefore younger people avoid adhering to treatment regarding depression as they feel they are been misdiagnosed (Haigh et al., 2018). Some people also neglect adhering to care regarding depression because they feel they are not sick and have no risk towards health (Saini et al., 2018). However, the stress and depression overtime cause imbalance in the neurological function and leads people to cause elf-harm and suicide (Saini et al., 2018). The perceived barriers are the obstacles and believes which influences adherence to treatment by patients and public (Luquis and Kensinger, 2019). In some cultures and rural areas, people consider depression not to be an health disorder and consider wastage of money in availing care regarding it or shame for the family to avail care regarding depression as mental health issue is demeaning to the image of the family (Lopez et al., 2018). This differential thinking toward considering depression not to be a health issue lead the people to avoid adhering to any care regarding it. Moreover, people who do not access support from the family members or community makes the people suffering from depression avoid adhering to the treatment out of lack of recognition of the condition to be a health issue that requires care (Lopez et al., 2018). According to HBM, the modifying variables such as demographic (sex, age, gender), psychosocial (peer pressure, social class) and structural influence non-adherence of people toward treatment (Luquis and Kensinger, 2019). This is evident as people from the lower social class who lack education are seen to non-adhere to the treatment of depression and suffer from the health issue as they cannot understand the presence of the disease as well as its severity (Freeman et al., 2016). The lack of cues to actions is tha trigger necessary for maintaining adherence to treatment and self-efficacy that is personal competence to follow a behaviour lead to create non-adhere to treatment by people (Huang et al., 2018). This is because without the trigger the people do not feel encouraged to follow the treatment and lack of self-efficacy leads individual to be dependent of care for others which may not always be available for them, in turn, creating non-adherence of treatment by the individuals. In case of people with depression, the lack of trigger and personal competence to follow care does lead them to non-adhere to treatment. This is because they feel the mentioned treatment is useless and not required in turn making them remain isolated and suffer from the disease (Sirey et al., 2017).

Conclusion

The discussion informs that according to Medication Adherence Model, the lack of purposeful actions, positive feedback regarding care and adequate information about patterned behaviour leads patient to non-adhere to the treatment. This is evident in case of patients with depression who on feeling lack of purpose of the mentioned treatment and having negative feedback regarding their care avoid adhering to the treatment as they feel it to be waste of money and time. According to Health Belief Model, the lack of perceived susceptibility and severity that depression is a major health issue along with lack of information regarding the need of care provided for the health issue leads individual non-adhere to the treatment of depression.

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References

Argent, R., Daly, A. and Caulfield, B., 2018. Patient involvement with home-based exercise programs: can connected health interventions influence adherence?. JMIR mHealth and uHealth, 6(3), p.e47.

Ding, A., Patel, J.P. and Auyeung, V., 2018. Attitudes and beliefs that affect adherence to provider-based complementary and alternative medicine: A systematic review. European Journal of Integrative Medicine, 17, pp.92-101.

Emilsson, M., Gustafsson, P.A., Öhnström, G. and Marteinsdottir, I., 2017. Beliefs regarding medication and side effects influence treatment adherence in adolescents with attention deficit hyperactivity disorder. European child & adolescent psychiatry, 26(5), pp.559-571.

Esparza-Del Villar, O.A., Montañez-Alvarado, P., Gutiérrez-Vega, M., Carrillo-Saucedo, I.C., Gurrola-Peña, G.M., Ruvalcaba-Romero, N.A., García-Sánchez, M.D. and Ochoa-Alcaraz, S.G., 2017. Factor structure and internal reliability of an exercise health belief model scale in a Mexican population. BMC public health, 17(1), p.229.

Freeman, A., Tyrovolas, S., Koyanagi, A., Chatterji, S., Leonardi, M., Ayuso-Mateos, J.L., Tobiasz-Adamczyk, B., Koskinen, S., Rummel-Kluge, C. and Haro, J.M., 2016. The role of socio-economic status in depression: results from the COURAGE (aging survey in Europe). BMC public health, 16(1), p.1098.

Green, E.C., Murphy, E.M. and Gryboski, K., 2020. The Health Belief Model. The Wiley Encyclopedia of Health Psychology, pp.211-214.

Haigh, E.A., Bogucki, O.E., Sigmon, S.T. and Blazer, D.G., 2018. Depression among older adults: a 20-year update on five common myths and misconceptions. The American Journal of Geriatric Psychiatry, 26(1), pp.107-122.

Henssler, J., Kurschus, M., Franklin, J., Bschor, T. and Baethge, C., 2018. Trajectories of acute antidepressant efficacy: how long to wait for response? A systematic review and meta-analysis of long-term, placebo-controlled acute treatment trials. The Journal of clinical psychiatry, 79(3), pp.1-20.

Huang, Y.M., Shiyanbola, O.O. and Smith, P.D., 2018. Association of health literacy and medication self-efficacy with medication adherence and diabetes control. Patient preference and adherence, 12, p.793.

Jeong, J.Y. and Ham, S., 2018. Application of the Health Belief Model to customers' use of menu labels in restaurants. Appetite, 123, pp.208-215.

Jung, S. and Tak, S.H., 2019. Medication Non-adherence and Related Factors of Older Adults Who Use Polypharmacy Based on Medication Adherence Model. The Journal of the Korea Contents Association, 19(12), pp.398-406.

Khalifeh, A. and Hamdan-Mansour, A., 2020. Prevalence, Barriers, and Interventions related to Medication Adherence Among Patients Diagnosed with Major Depressive Disorder: A Scoping Review. Authorea Preprints. Pp.1-57

Lopez, V., Sanchez, K., Killian, M.O. and Eghaneyan, B.H., 2018. Depression screening and education: an examination of mental health literacy and stigma in a sample of Hispanic women. BMC public health, 18(1), p.646.

Luquis, R.R. and Kensinger, W.S., 2019. Applying the health belief model to assess prevention services among young adults. International Journal of Health Promotion and Education, 57(1), pp.37-47.

Obata, H., 2017. Analgesic mechanisms of antidepressants for neuropathic pain. International journal of molecular sciences, 18(11), p.2483.

Read, J. and Williams, J., 2018. Adverse effects of antidepressants reported by a large international cohort: emotional blunting, suicidality, and withdrawal effects. Current drug safety, 13(3), pp.176-186.

Saini, P., Chantler, K. and Kapur, N., 2018. GPs’ views and perspectives on patient non-adherence to treatment in primary care prior to suicide. Journal of Mental Health, 27(2), pp.112-119.

Singh, S., Zaki, R.A. and Farid, N.D.N., 2019. A systematic review of depression literacy: knowledge, help-seeking and stigmatising attitudes among adolescents. Journal of Adolescence, 74, pp.154-172.

Sirey, J.A., Banerjee, S., Marino, P., Bruce, M.L., Halkett, A., Turnwald, M., Chiang, C., Liles, B., Artis, A., Blow, F. and Kales, H.C., 2017. Adherence to depression treatment in primary care: a randomized clinical trial. JAMA psychiatry, 74(11), pp.1129-1135.

WHO 2020, Adherence to Long-Term Therapies: Evidence For Action, Available at: https://www.who.int/chp/knowledge/publications/adherence_report/en/ [Accessed on: 2 January 2021]

Wu, S., Feng, X. and Sun, X., 2020. Development and evaluation of the health belief model scale for exercise. International journal of nursing sciences, 7, pp.S23-S30.