Posters

Academic Level (Author 1)

Medical Student

Discipline/Specialty (Author 1)

Internal Medicine

Discipline Track

Clinical Science

Abstract

According to the World Health Organization (WHO), over 10-25% of hospital admissions result from patient noncompliance. This is a complex issue that has vast ripple effects as it not only worsens outcomes for patients but places a strain on the healthcare system entirely. In patients with HIV/AIDS, compliance with Antiretroviral therapy (ART) is necessary to prevent a host of potentially lethal infections.

A 33-year-old female with AIDS, presented to the ED complaining of nausea and vomiting for seven days. Throughout her hospital stay, the patient was regarded as medically noncompliant with daily episodes of refusing medications, hiding pills in her bed or under her tongue, or simply throwing them in the trash. Numerous physicians explored the reasoning behind her non-compliance, to which she was evasive, making attempts to leave against medical advice.

The patient in this case was diagnosed with HIV 8 years prior, and was admittedly nonadherent to her prescribed ART therapy. Her HIV ultimately progressed to AIDS with a low CD4 count, leaving her vulnerable to a variety of opportunistic infections, such as cryptococcal meningitis. Presumably, the solution to this problem begins in understanding the person beneath the diagnosis. With boundaries to patient compliance such as patient-physician miscommunication and treatment fatigue, clinicians are tasked with the responsibility of recognizing these obstacles and beginning an open discussion about potential solutions. As a medical community, we must not be pigeonholed into thinking noncompliance is an unavoidable consequence of patient lack of self-investment or the public's' misunderstanding.

Presentation Type

Poster

Share

COinS
 

Building the “Crypt” Through Non-Compliance: A Case of Cryptococcal Meningitis in an AIDS patient

According to the World Health Organization (WHO), over 10-25% of hospital admissions result from patient noncompliance. This is a complex issue that has vast ripple effects as it not only worsens outcomes for patients but places a strain on the healthcare system entirely. In patients with HIV/AIDS, compliance with Antiretroviral therapy (ART) is necessary to prevent a host of potentially lethal infections.

A 33-year-old female with AIDS, presented to the ED complaining of nausea and vomiting for seven days. Throughout her hospital stay, the patient was regarded as medically noncompliant with daily episodes of refusing medications, hiding pills in her bed or under her tongue, or simply throwing them in the trash. Numerous physicians explored the reasoning behind her non-compliance, to which she was evasive, making attempts to leave against medical advice.

The patient in this case was diagnosed with HIV 8 years prior, and was admittedly nonadherent to her prescribed ART therapy. Her HIV ultimately progressed to AIDS with a low CD4 count, leaving her vulnerable to a variety of opportunistic infections, such as cryptococcal meningitis. Presumably, the solution to this problem begins in understanding the person beneath the diagnosis. With boundaries to patient compliance such as patient-physician miscommunication and treatment fatigue, clinicians are tasked with the responsibility of recognizing these obstacles and beginning an open discussion about potential solutions. As a medical community, we must not be pigeonholed into thinking noncompliance is an unavoidable consequence of patient lack of self-investment or the public's' misunderstanding.

 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.