CU Nursing - Spring/Summer 2021 - 21

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RESEARCH & SCHOLARSHIP

New Study Finds Real
Life Makes Following
Doctor's Orders
Difficult To Manage
Chronic Disease
BUSY SCHEDULES, HOLIDAYS AND TRAVEL CAN
RESULT IN WRONG, DANGEROUS DOSING

By Deborah Mandeville

any patients with chronic disease may
intend to follow their doctor's orders to
diet, take their medicine and exercise,
but a new study finds that everyday
life often gets in the way. When that
happens, the study found patients can
become stressed and overwhelmed and might lie about
dosing or even create their own remedies.
The findings were released in a study led by Mustafa
Ozkaynak, PhD, at the University of Colorado College
of Nursing, and published January 18, 2021 in JMIR
Publications.
" This highlights a significant gap between what clinicians
ask of patients and what is actually happening when they
get home and self-manage their chronic disease, " said
associate professor Mustafa Ozkaynak. " It points to the
need for better management systems with technology,
more collaboration, and recognition about how patients'
social environments impact their health care. "
The 39 patients involved in the study were being treated
with the medicine Warfarin, an anticoagulant that prevents
clots from forming in the blood. While the patients received
specific directions from their doctors about dosing, some
patients told researchers they had trouble remembering
when to take it, and struggled to fit the habit into their
busy work and family lives. When doctors later asked if
they'd missed taking any medication, some patients said,
" I usually lie to [providers]...because it was easier. " Other
patients changed their dosing to treat symptoms as they
saw fit, according to the study.

Patients also struggled to routinely perform
therapy-related activities because of their social
and extracurricular activities. Holidays, travel and
religious and seasonal events also made it difficult
for them to complete their physical therapy.
The study also showed patients had trouble following the doctor's advice to follow a specific diet
for their chronic disease. Some patients snuck in
forbidden foods. Others, who were not allowed
to drink, drank anyway, then " took in even more
greens to counteract the alcohol. "
Researchers recommend clinicians take big steps
to understand how social, environmental, personal
and economic factors impact patients' abilities to
follow medical and physical therapy orders. Those
steps, the study says, should include collaborative
health information technologies, novel education
initiatives and programs that integrate health care
and community resources.
The study co-authors include: Rupa Valdez PhD,
Department of Public Health Sciences, University of
Virginia, Charlottesville, VA; Katie Hannah MPH,
College of Nursing, University of Colorado-Denver;
Gina Woodhouse BHc, University of Colorado
Hospital, Aurora, CO; and Patrick Klem PharmD,
University of Colorado Hospital, Aurora, CO

Mustafa
Ozkaynak, PhD

CU Nursing - Spring/Summer 2021

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