determine
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You diagnose a 40-year-old woman with depression and prescribe an antidepressant. Which one of the following factors would increase the likelihood of her compliance with treatment?
1) a positive family history
2) the patient's denial of her illness
3) marked secondary gain
4) a high level of subjective distress
5) short waiting-room time
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| babli
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3) marked secondary gain
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| determine
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1?
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| achilles
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1 ??
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| AAAAA
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3 Only Marked secondary gain patient takes medication for the sake of welfare, disability checks, and sick leave and leave of absence.
This marked secondary gain will re-inforce patient is sick and he or she is deserved to get a secondary gain-------> $$$$$ Money--->cheque, welfare cheque, disability check
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| p53
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5) short waiting-room time - it's one of the compliance rules from 'BRS Behavioral Science'!
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| AAAAA
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Compliance of treatment---> taking her anti-depressants----------->taking her medication for treatment------->? short waiting room ?
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| AAAAA
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What the question asks you is you saw a patient, made the diagnosis of depression and wrote a prescription and now what will make her take her medication (complaint with the treatment plan )?
They did not ask you what will make the patient to come to see you ? short waiting room time is sure makes the patient easily to see you !
But what makes the patient to take her med, I don't think short waiting room time is the answer ?
??
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| p53
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AAAAA, thank you for your explanation, but I know what does the word 'compliance' mean
- patient gets angry with long waiting time and then is unwillng to follow your prescriptions.
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| Rasul
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Ok, just for the sake of opinion: 4-high level of subjective distress.Example: If patient is really in pain-he will stick to pain med Tx...If pt feels really bad (severe distress by signs and symptoms of depression)-she'll stick to the meds.
What do You, guys, think?
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| AAAAA
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Regular medical pt takes pain med
But psychiatric patient in many cases does not take their medication
The question really asks you how to make psychiatric patients either depressed or crazy, yes crazy patients take their medication?
Now you understand why MCC ask this question ?
How you make the patient compliant or the patient willing to take medication (a crazy patient or depressed patient ??)
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| mesh
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5 short waiting room time.....
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| yasmeen
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5 short waiting room time good doctor pt relationship inc pts compliance
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| frontal
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4 strikes me as correct for the reason already mentioned by Rasul.
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| yasmeen
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do you know the answer determine.
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| seri
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i'd say the answer is between 4 and 5
short waiting room time is a good predictor of good rapport with dr. which in turn is a good compliance
subjective distess might make thge pt do something about it viz take meds, but it depends on pts attitude to meds (belief whether they will work, understanding of its importance etc) ultimately compliance is most influenced by pts relationship with dr, hence i'd choose 5
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| frank100
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4 I thnk
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| juanma0
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I say 4 here´s why : In the health belief model the perception of distress is equal to the perceived threat of disease. By increasing the perceived threat of disease that patient has an increased likelihood of taking the recommended measure. Also is is true for positive family history but this only helps increase the "subjective distress". Any thoughts guys?
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| nadiabarati
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For sure 5. totally agree with p53. This is what BRS BS says.
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| Surfer
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I go for 4, as not only does the patient know that she has a problem, but also the disease is distressing and suffuring to her.
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| tolito
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5.
the curve is an inverted U for level of distress and compliance. a low distress level gives low compliance and a moderate level gives best compliance while a high level gives a low compliance. so a moderate level of fear or distress is what we want to achieve in our patients. ....BRS.
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| study_ing
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secondary gain-->Interpersonal or social advantages gained indirectly from organic illness, such as an increase in attention from others. (it is unconscious)
so id say treatment wud reduce it...hence id rule that out as an option.
1 and 2 id definitely vote against.
short waiting time and subjective stress is a confusion.
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| brokenhearted
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if they get a secondary gain then they will have decreased compliance b/c they'll know that after taking meds they'll get better in a couple of months & then whatever secondary gain they'll get will go away from them so if they are getting sec gain from their illness they'd wanna stay ill for longer time & keep getting sec gains.
My personal opinion is decreased waiting room time this is what a docotr can personally do for the patient....at 1st I was confused b/n 4 & 5 but then Nadia explained it real good so it is 5.
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