Items - 12 questions related to why the person missed one or more doses,
Some additional items that could be added:
(13) I ran out of pills.
(14) I was intoxicated at the time.
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Responses
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Points
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not a problem
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0
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mild problem
|
1
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moderate problem
|
2
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serious problem
|
3
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total score =
= SUM(points for all of the items)
Interpretation:
• minimum score: 0
• maximum score: 36 with original score, 42 with modified score
• The higher the score the greater the problem with adherence.
Possible responses to problems identified:
(1) Try to simplify the regimen.
(2) Employ dosage aids (pill dispensers, timers, etc.) to help standardize and adhere to the regimen.
(3) Evaluate for evidence of a change in mental status (confusion, dementia, etc.)
(4) Evaluate for anxiety and depression.
(5) Shift to less toxic regimen.
(6) Educate on the benefits vs risk of the regimen.
(7) Include the patient in the decision making process.
(8) Target specific risk times (travel, vacation, etc.)
(9) Use a daily dosage diary.
(10) Evaluate for substance abuse problems.
(11) Evaluate for disease progression.
(12) Evaluate for complications of the disease.
(13) Evaluate for adverse effects from the medications.
(14) Elicit help from family and friends.
(15) Develop reminders for when to refill medications.
