Describe what psychologists have discovered about improving adherence to medical advice.

Mark scheme

Marking points from the official mark scheme (Oct/Nov 2021). The mark or mark type is shown in brackets.

1. [1] Adherence to medical advice can be improved by enhancing practitioner style (Ley, 1988).
2. [1] Adherence to medical advice can be improved by using behavioural techniques (Yokley and Glenwick, 1984; Watt et al., 2003).
3. [2] Ley (1988) reviewed GP and hospital patients, finding 28% in UK had low satisfaction with treatment and 41% with doctor interaction.
4. [1] Patients are 'information seekers'.
5. [1] Improving practitioner style leads to greater adherence, focusing on satisfaction (e.g., listening to patient worries).
6. [1] Improving understanding and memory (avoiding jargon, encouraging feedback, patient repeating instructions).
7. [1] Selecting content (being aware of the effect of what they say, potential fear).
8. [1] Using simple language, stating key information first, repeating key points (summarising), using written information or a combination of oral and written methods (e.g., diagrams).
9. [2] Yokley and Glenwick (1984) aimed to evaluate the relative impact of 4 conditions for motivating parents to take their children to be immunised.
10. [1] The target population consisted of children 5 years or younger needing inoculations in a medium-sized mid-west city (population ~300 000).
11. [1] The conditions included: mailed general prompt.
12. [1] mailed specific prompt.
13. [1] mailed specific prompt plus expanded clinic hours (increased access, convenience condition).
14. [1] mailed specific prompt plus monetary incentive (i.e., lottery).
15. [1] Control groups included contact control (telephone contact for basic info) and no contact.
16. [1] The impact was measured over 12 weeks based on attendance for immunisation injections.
17. [1] Results showed the monetary incentive group had the biggest impact, followed by increased access, specific prompt, and general prompt groups respectively.
18. [2] Watt et al. (2003) studied 32 Australian children (10 m, 22 f, age range 1.5–6 years; mean age 3.2 years) with asthma for 2.2 years.
19. [1] Questionnaires were completed after using the Breath-a-Tech (current market leader, a 'spacer') and then a Funhaler over two sequential weeks.
20. [1] The Funhaler provides incentive (spinning disc and whistle) for correct medication usage.
21. [1] There was no significant difference in the quantity of medication delivered by the two devices.
22. [1] 38% more parents medicated their child daily using the Funhaler compared to the standard Breath-a-Tech method.
23. [1] 60% more children adhered to the recommended dosage of 4 or more cycles of drug delivery with the Funhaler compared to the traditional method.
24. [2] Named issue – experiments – Yokley is independent measures design, Watt is repeated measures design but both could be classed as field experiments.
25. [1] Some variables hard to control in both studies.
26. [1] However, standard procedure used and clear manipulation of IV so could be seen as both valid and reliable.
27. [1] It can be difficult to measure levels of adherence as the patient's parents can lie and say their children did adhere more than they actually did.
28. [1] However, the Yokley study did keep records on the actual number of immunisations so is free from this bias.
29. [2] In addition, the Watt et al. study was able to objectively compare how much of the asthma medication was actually used by both the funhaler device and a traditional device which is also more objective.
30. [1] Ethics.
31. [1] Generalisability.
32. [1] Usefulness.
33. [1] Reductionism.
34. [1] Determinism.