8/7/2019 PDFMy Journey in Medication Compliance
1/25
A PATIENTS PERSPECTIVE
PAMELA MEADOWS, RN
WILSONS DISEASE PATIENT
8/7/2019 PDFMy Journey in Medication Compliance
2/25
Mosby's Medical Dictionary defines health
behavior as:
An action taken by a person to maintain,
attain, or regain good health and to preventillness.
8/7/2019 PDFMy Journey in Medication Compliance
3/25
Adherence and non-adherence are
Health behaviors. If a person is
non-adherent totheir medication regimen, a behavior
change is required to improve
adherence.
8/7/2019 PDFMy Journey in Medication Compliance
4/25
The Wilson Disease Center for Excellence at
the University of Michigan, lead by Dr. Fred
Askari, states that Compliance can be
difficult particularly for people who do nothave disease symptoms, for people who have
an inability to focus, or for people who have
depression.
8/7/2019 PDFMy Journey in Medication Compliance
5/25
I have experienced all three of
these contributing factors in my
journey of medicationcompliance/adherence.
8/7/2019 PDFMy Journey in Medication Compliance
6/25
APRIL 2001:DIAGNOSED
WITHWILSONSDISEASE
MAY 2001:
WENT ONGALZIN:
ABSOLUTELYCOULD NOTTOLERATE
JUNE 2001:WENT ON GNC
OVER THECOUNTER ZINC
Asymptomatic
ScaredResearched WD;
only wanted to
take zinc
Still
scared;
switched
meds
The beginningof
non-complianceTakingmedication with
prohibited
foods, liquids,other
medications
Omitting a dose
or taking at thewrong time
8/7/2019 PDFMy Journey in Medication Compliance
7/25
2002-2005 NURSINGSCHOOL; ENZYMES
CREEPING UP,DOCTOR SUGGESTINGSYPRINE; INSTEAD, I
SWITCH TO ANOTHEROTC ZINC
2005-2007 STILLPETRIFIED OF SIDE
EFFECTS OF WILSONSDISEASE
MEDICATIONS;REFUSED TO TAKEANYTHING OTHER
THAN ZINC
2007 MOVED TOCOLORADO
GOT NEWHEPATOLOGIST
2007-2009
LIVER ENZYMES DIDNOT IMPROVE
Scared ofside
effects;
didnt
trust MD
Still very scared of side
effects; comorbidities
Personal Stress at
all-time high. Still
afraid of side
effects.
Co-morbidities
worsening.
8/7/2019 PDFMy Journey in Medication Compliance
8/25
AgranulocytosisAlopeciaAnorexia, epigastricpain, nausea,vomiting,diarrheaAplastic anemiaBlurred visionCutaneous maculDegenerative changesof the skin (especiallyof the neck)
Initialhypersensitivity:hives, rash, fever,anaphylaxis,lymphadenopathy
Nephrotic syndromeObliterative bronchitisOptical axial neuritisOral ulcerationsProteinuriaPtosisSerous retinitisThrombocytopenia ortotal aplasiaserpiginosa EPSlesionsGoodpastures
syndromeHypogeusia
HepatotoxicityHyperkeratosisIntrahepaticcholestasisLeukopeniaLichen planusLupus-like reactionMammary hyperplasiaMyasthenic syndromeAgeusiaatrophyDepression of serum
IgA levelsDiplopiaElastosis perforans
8/7/2019 PDFMy Journey in Medication Compliance
9/25
8/7/2019 PDFMy Journey in Medication Compliance
10/25
Peers warning about medication side effects:
I dont know if I would let the doctor put me onthat much right away.its awfully risky
The nurse in me. Its true.Sometimes we are our worst enemy.we can
know too much that hinders our owncompliance.
Afraid of the doctors ignorance on managingmy medications.
I did not have a trusting relationship with mydoctor.
8/7/2019 PDFMy Journey in Medication Compliance
11/25
Complexity of medication regimen:
I have several other health issues that requiretaking medications, and taking them a specificway. Several are more than once daily. Severalhave to be on an empty stomach, apart fromfood and other meds. Several have to be withfood. This is very frustrating, and causes meinconvenience, because I have an extremely
Busy life:
I work fulltime, attend graduate school full time,and have several regularly scheduledcommitments outside of these things. I get tiredof taking medications, and trying to take themall correctly.
8/7/2019 PDFMy Journey in Medication Compliance
12/25
8/7/2019 PDFMy Journey in Medication Compliance
13/25
Stress
My personal life has been turned upside downin the past two years with a divorce, mydaughter moving 2,000 miles from me,
financial stressors and.
Physical Challenges
My liver and spleen issues; cholecystitis andkidney stone
Severe thyroid issues causing extreme loss ofenergy, loss of concentration, severe muscleaches and short stents of depression
Keeping my diabetes under control
8/7/2019 PDFMy Journey in Medication Compliance
14/25
In early 2009, eight years into my WD
diagnosis, I was at work, and felt funny. I
looked at my colleague and said, I can feel
my spleen. It feels swollen.
I called my specialist, who had scans done
immediately, and sure enough, my liver was
enlarged more and so had my spleen.
8/7/2019 PDFMy Journey in Medication Compliance
15/25
What do I do now? I
broke down and decidedto take a stronger
medicine. Syprine was
the drug of choice.
8/7/2019 PDFMy Journey in Medication Compliance
16/25
Within six months of beginning
Syprine, all of my WD laboratory
tests were normal. Even my liverfunction tests were all
completely normalfor the first
time since my WD diagnosis! Ihad no unpleasant side effects
from Syprine, either.
8/7/2019 PDFMy Journey in Medication Compliance
17/25
8/7/2019 PDFMy Journey in Medication Compliance
18/25
I empower myself. While I do value and need clinicians,only I am ultimately responsible for my own health. I stayeducated, and in charge of my own health.
I understand potential impact of diagnosis. Beingasymptomatic, I MUST remember this at all times.
I know the prescribed treatment will help. I know exactly how to take the medication and I realize
this is a life-long treatment.
I am ultimately in charge of making sure my treatmentplan is carried out.
I value the outcome of treatment more than the cost
of the treatment. (Waking up early, being inconvenienced) I find ways to fit medication regimen into my daily routine.
I have a health care provider that I trust and one who trulycares.
8/7/2019 PDFMy Journey in Medication Compliance
19/25
There is usually no single reason for
medication non-adherence, therefore there
can be no one size fits all approach to
improving adherence.
Address the problems and reinforce positive
behaviors. Get regular follow ups. You must
have a trusting relationship with your
provider. Have a support system in place toencourage you.
8/7/2019 PDFMy Journey in Medication Compliance
20/25
8/7/2019 PDFMy Journey in Medication Compliance
21/25
8/7/2019 PDFMy Journey in Medication Compliance
22/25
8/7/2019 PDFMy Journey in Medication Compliance
23/25
8/7/2019 PDFMy Journey in Medication Compliance
24/25
8/7/2019 PDFMy Journey in Medication Compliance
25/25
Askari, Fred MD. (2009). Wilson Disease
Center for Excellence. University of
Michigan.
http://www.med.umich.edu/gi/wilsonsdisea
se/
Feinberg, Janice L. PharmD, JD (2006). ASCP
Foundation.
Mosby's Medical Dictionary. (2009). 8thedition. Publisher: Elsevier.
http://www.med.umich.edu/gi/wilsonsdisease/http://www.med.umich.edu/gi/wilsonsdisease/http://www.med.umich.edu/gi/wilsonsdisease/http://www.med.umich.edu/gi/wilsonsdisease/Top Related