CHALLENGES AND LIMITATIONS IN APPLAYING ADHERENCE IN THE EVERYDAY PRACTICE OF HEALTHCARE WORKERS
Keywords:
adherence, methods, healthcare, patientsAbstract
Medical adherence serves as a link between the healthcare system and the patient. Barriers and challenges encountered in adherence implementation are a daily reality, posing a significant challenge in treating various health conditions. Methods for measuring aherence levels are categorized into several types, including direct and indirect methods, each with its own advantages and drawbacks. Patients face disadvantages such as insufficient disease control, lack of awareness, inadequate education of healthcare staff, poor patient disease issues, among others. This research involved 200 participants who provided their opinions on the state of medical adherence implementation, whether satisfactory or unsatisfactory. The majority of participants agreed on the very poor implementation of medical adherence, indequate organizational structure within healthcare institutions, issues within the healthcare system, indequately effective adherence measurments methods, while a smaller numer of participants held a different perspective. Additionally, medical adherence is not adequately represented in the daily operations of healthcare professionals due to numerous limitations and barriers faced by healthcare workers. One of the key barriers and obstacles is the lack of sufficient knowledge and skills, a result of the absence of adequate formal and informal education systems. Medical adherence influences more professional job preformance, enhancing the overall quality of the healthcare delivery system. The organization of tasks and the working system in healthcare institutions do not encourage an increase in patient adherence, posing a significant challenge and limitation in the implementation of medical adherence. The absence of instructions and adequate knowledge about measuring the degree of patient adherence prevents healthcare employees from actively participating in reducing patient non-adherence. Numerous issues within the healthcare system in Bosnia and Herzegovina transfer to healthcare institutions providing healthcare services. One major problem is the lack of adequate financial resources necessary not for normal operations but also for improvements in healthcare delivery. One way to increase motivation among employees is through financial support in the form of rewards and incentives. None of the respondents mentioned that the motivation system, especially incentives, serves as way increase the level of medical adherence. It is necessary to enhance the curruculum of formal education, specifically the educational institutions that educate future healthcare workers. The role and significance of adherence in the treatment process have been recognized by the WHO, partly due to numerous studies conducted worldwide, indicating the role and importanceof adherence. It is also important to establish an adherence system of continous education that recognizes the rol and significance of medical adherence. The includes creating a model for informing and educating healthcare employees through internal and external training and seminars. Educating healthcare workers about medical adherence is a key factor in increasing the level of medical adherence in healthcare institutions. The research results indicate the conclusion that healthcare workers are intrasted in and make individual efforts in education, but these efforts are insufficient, among other reasons, due to the research results presented in the previous chapter of the paper. In order to increase the implementation of medical adherence, which, based on research results, affects the more professional preformance of healthcare workers and influences treatment outcomes, it is necessary to create a strategy whose implementation should result in reducing or eliminating the barriers faced by healthcare workers in their daily work with patients. The healthcare system in Bosnia and Herzegovina needs to develop a strategy to enhance the implementation of medical adherence in healthcare and establish a foundation for creating specific activities within healthcare institutions. Undoubtedly, one of the biggest challenges is creating an adequate system, reducing the burden on healthcare employees, and finding necessary financial resources. Certain recommendations presented require significant financial resources and cannot be realized in a short period. It is also possible to improve the curriculum of educational institutions, creating internal and external training programs aimed at increasing knowledge, skills and practical advice for future and current healthcare workers. By investing in education, we invest in the future and in this context, in the nation's health.
References
Anghel, L. A., Farcas, A. M., Oprean, R. N. (2019). An overview of the common methods used to measure treatment adherence. Medicine and Pharmacy Reports, 92(2), 117.
Cea-Calvo, L., Marín-Jiménez, I., de Toro, J., Fuster-RuizdeApodaca, M. J., Fernández, G., Sánchez-Vega, N., Orozco-Beltrán, D. (2020). Association between non-adherence behaviors, patients’ experience with healthcare and beliefs in medications: a survey of patients with different chronic conditions. Current Medical Research and Opinion, 36(2), 293-300.
Gandolfini, I., Palmisano, A., Fiaccadori, E., Cravedi, P., Maggiore, U. (2022). Detecting, preventing and treating non-adherence to immunosuppression after kidney transplantation. Clinical Kidney Journal, 15(7), 1253-1274.
Gutiérrez-Crespo, H., Huaman-Carhuas, L., Cehua-Alvarez, E. A., Matzumura-Kasano, J. P., Valdeiglesias-Ochoa, D. (2023). Adherence and barriers to contraceptive use in young adult women attending first level health care facilities, Peru. Medicina Clínica y Social, 7(2), 84-94.
Jarak, A. (2019). Stavovi i uvjerenja pacijenata na terapiji antidepresivima, inhalacijskim kortikosteroidima i statinima (Doctoral dissertation, University of Zagreb. Faculty of Pharmacy and Biochemistry. Centre for applied pharmacy).
Kuypers, D. R. (2020). From nonadherence to adherence. Transplantation, 104(7), 1330-1340.
Kvarnström, K., Westerholm, A., Airaksinen, M., Liira, H. (2021). Factors contributing to medication adherence in patients with a chronic condition: a scoping review of qualitative research. Pharmaceutics, 13(7), 1100.
Nikolić, A., Nikolić, A., Grujičić, S. (2022). Sinonim sagorevanaj lekara i medicinskih sestara/tehičara zaposlenih u Opštoj bolnici zdravstvenog centra u Brčkom: Zdravstvena Zaštita, 51(4).
Panahi, S., Rathi, N., Hurley, J., Sundrud, J., Lucero, M., Kamimura, A. (2022). Patient adherence to health care provider recommendations and medication among free clinic patients. Journal of Patient Experience, 9, 23743735221077523.
Walsh, C. A., Cahir, C., Tecklenborg, S., Byrne, C., Culbertson, M. A., Bennett, K. E. (2019). The association between medication non‐adherence and adverse health outcomes in ageing populations: a systematic review and meta‐analysis. British Journal of Clinical Pharmacology, 85(11), 2464-2478.