Stroke Accounts For 11.13% Of Total Worldwide Mortality

stroke is an acute episode of focal dysfunction of the brain, retina, or spinal cord lasting longer than 24 h, or of any duration if imaging (CT or MRI) or autopsy show focal infarction or haemorrhage relevant to the symptoms ,which is a leading cause of death and long term disability worldwide. It results from transient or permanent disruption of cerebral blood flow, leading to necrotic death of the brain tissue supplied by the affected artery. It activates an inflammatory condition in the affected area, marked by infiltration of inflammatory cells. Inflammation can induce an apoptotic cell death in the transition region between necrotic and normal tissue, so called penumbra, for a fairly prolonged period of time.[1].

Strokes are caused by pathophysiological changes. The two major mechanisms of stroke consist of ischemia and haemorrhage. Ischemia is when there is no oxygen or not, merely enough oxygen to fuel the tissue level in the body. Haemorrhage in the brain, causing strokes can be due to non-traumatic intracerebral haemorrhage (Shah, MD, n.d.) (see appendix 1). This essay will further discuss the implications of strokes on a cellular, organ and system level. Explain the clinical presentation of the signs and symptoms of strokes and how the condition will be managed by a paramedic.

Some of the factors that patients do not adhere to when their healthcare provider tells them too is due to patients being too busy. Often times life is very busy as we all know this but forgetting to take of yourself can have detrimental effects to your health. Some people think they can get better on their own without the help of a doctor so they feel like they will be fine or able to handle any health complication on their own. Another reason is that often people do not understand or they forget what the doctor is telling them about their prescribed treatment regimens and other patients decide to simply not follow it. As stated in the article by Sklar, Min Sen Oh & & Chuen Li, 2008 “Poor communication with healthcare providers was also likely to cause a negative effect on patient’s compliance (Bartlett et al 1984; Apter et al 1998)”. Miscommunication between a doctor and patient is at the root of most adherence problems. Often times patients leave their doctors office not knowing or having the slightest clue to what they should be doing. Instead of asking for help or clarity they just leave. Communication needs to be clear and effective for both the patient and the doctor. Non-adherence is wide spread when it comes to patients not adhering to what professionals tell them. Many patients will have significant risks because they forget,

Medication adherence is described as the extent to which the patients take medication as prescribed by the health care provider. To ensure the patients receive proper care, health care systems must implement procedures to successfully meet their needs and overall improve their quality of life. However, there are several reasons that affect proper medical care, which ultimately results in an increase in health care expenses and poorer health outcomes for patients. Studies have shown that approximately 50% of patients do not take their chronic medications as prescribed and that nonadherence can cost the health care system nearly $100 to $289 billion per year (1). Medication adherence is difficult to achieve due to ineffective communication between

Patient Adherence: There is no known cure for chronic disease, the progressive nature of chronic disease the patient and family must adjust to continual treatment changes, and the chronic disease continues throughout the patient’s lifetime developmental and lifestyle changes often influence or pose additional challenges to the person with a chronic

Adherence is defined as the extent to which a person's behaviour in taking medication which requires the person's agreement to the recommendations for treatment from health care provider(4) to achieve healthy lifestyle. (7) In the situation that not following the health care provider’s orders correctly, it is known as the medication non-adherence. Medication non-adherence will lead to multidimensional health care problem. (1) Non-adherence of medication will be occured among patients during different stages of their therapy.

In conclusion, addressing the problem of non-adherence would help alleviate the burden of added costs to healthcare. When patients take their medications as prescribed, they are considered to be adherent. Adherence has two components that are complementary to each other: persistence and implementation

When referring to M.M.’s treatment regime, adherence is an area where continued encouragement is needed. M.M. has a medication schedule that is PRN except for the three days leading up to her treatment. During those three days a steroid and antiemetic are given prophylactically to decrease side effects. However, because of the complexity of her treatment plan she does not take them because she is not nauseous or in pain. This has led to postponement of treatments and continued reiteration on her treatment plan, which she seems to support fully. M.M.’s adherence issue I feel is attributed to the complexity of her situation. According to Richards (2014) noncompliance can be related to many issues some of which including knowledge, side effects, lifestyle and even motivation (p.221). It is important to avoid pressuring, guilt tripping, or coercing a patient into following a treatment plan. Sometimes continued reeducation can be a form of coercing a patient so I must be cautious and considerate in my approach (Richards, 2014, p. 221). Most of my education is patient led therefore they decide what they would like to discuss. Medications just happen to be a common

Mariam background is 60 year old lady admitted with left sided weakness and facial droop. Once confirmed stroke using the Recognition of Stroke in the Emergency Room (ROSIER) scale. Catangui (2015) states ROSIER scale is used to distinguish whether the patient is having a stroke or stroke mimics e.g. seizures or brain tumours. Computed tomography CT brain showed ischemic stroke. Ischaemic stroke is lack of sufficient blood supply to perfuse the brain/ cerebral tissue due to narrowing or blocked arteries in the brain (Morrison, 2014). According to Stroke Association (2015) statics shows that 1520000 strokes occur in the United Kingdom.

Medication adherence is one of the most important challenge in healthcare research due to its complexity and impact on overall health outcomes. The work suggests that non-adherence is frequent for all drug classes and the causes are attributed to characteristics of the medication itself, high cost of prescription drugs, lack of patient education and psychological variables. Most of the solution defined to address the level of non-adherence stresses the importance of developing HIT infrastructures. The collection and sharing of healthcare related data has been facilitated by the advances in ensuring EHRs while the patients are treated in hospital.

Controlling medication adherence is very important especially in chronically ill patients. There are many measurements to detect the medication non-adherence among patients. The measurements are all depend on the context, purpose, type of data, resources and user perspective. The methods available for detecting non-adherence are further divided into direct and indirect methods. Direct method mainly involved the direct observation by the pharmacists and the physicians.

Adherence to a treatment is one of the most important things that patients can do to restore their health. The reason for non-adherence might be due to a variety of factors, perhaps in this scenario the treatment is very long and complex. But, the consequences for the lack of adherence will be a load not only to the patient, but also to health care providers, and to society. Health care providers are regularly faced with dilemma, therefore it is important for them to be aware of their value system and be dedicated to it.

Nursing literature strengthens the medical view that non-compliance is a large problem that often comes with damaging consequences, often related to cost, re-hospitalization and relapses that might have otherwise been prevented (Russel, Daly, Hughes, & Hoog, 2003). Research indicates that a patient who is not satisfied will rarely comply with directions and often does not show up for return visits and this gives meaning as to why this is such an important topic. A show of statistics indicate that non-adherence to medications causes 125,000 deaths yearly and can be accounted for 10% to 25% of reported nursing home and hospital admissions in the United States alone (Atreja, Bellam, & Levy, 2002).

Non-compliance is expressed as the failure or refusal to comply. In this instance, it is used to reference a “patient who elicits through their behavior— the inability of taking medication, following a diet, executing lifestyle changes—or not corresponding with agreed recommendations from a health care provider” (McIntyre, 2016). Non-compliant behavior is actually believed to be an epidemic and is likely one of the most common causes of treatment failure for chronic conditions as it hinders the doctor’s ability to provide optimal care” (McIntyre, 2016). Patient education can

This confronts clinicians and families alike a new challenge: to ensure patient adherence to medication instructions. [9, 10] Adherence is defined as “the extent to which a person’s behaviour – taking medication, following a diet, and/or executing life style changes, corresponds with agreed recommendations from a health care provider”. [11] Patient adherence to the treatment regimen is paramount for the achievement of the intended therapeutic outcomes. Conversely, non-adherence might increase the potential for medication errors, drug interactions, and additional physician visits; it may also compromise clinical outcomes. [4, 11, 12, 13, 14] A study by McCowan et al, associates poor adherence with a shorter time to recurrence and a reduction in quality of life