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Medication compliance (synonym: adherence) refers to the degree or extent of conformity to the recommendations about day-to-day treatment by the provider with respect to the timing, dosage, and frequency. It may be defined as "the extent to which a patient acts in accordance with the prescribed interval, and dose of a dosing regimen."
- Joyce A. Cramer, Anuja Roy, Anita Burrell, Carol J. Fairchild, Mahesh J. Fuldeore, Daniel A. Ollendo...
- 2008
- Executive Summary
- Aconceptualmapandresearchagenda
- Terminology–compliance,adherence andconcordance
- Terminology recommendations
- Determinantsofmedication-taking behaviour
- Theme 1: Explaining medication-taking behaviour
- Theme 2: Patient-provider interactions and communication in healthcare
- Theme 3: Societal policies and practice
- Doing the right thing: the normative theme
- Theme 4: Interventions to facilitate adherence
- Conclusions and Recommendation
- Mappingresearchquestionsontothe SDOresearchpriorities
- Patient choice 7
- Adherence in vulnerable groups
- Disclaimer
RobHorne,JohnWeinman,NickBarber,RachelElliott, MyfanwyMorgan,AlanCribb&IanKellar Thisreportisaproductofascopingexercisecommissioned bytheNHSNationalCoordinatingCentreforService DeliveryandOrganisation(NCCSDO)withthefollowing aims: Summarisecurrentknowledgeaboutthedeterminants ofmedication-taking. Constructaconceptualmapoftheareaofcompliance, adhere...
Thesizeandscopeoftheliteratureonmedication-taking canmakeitdifficultforpractitionerstofindtheirway around.Thecomplexityofthetopicisillustratedbythefact thatthereareatleastthreetermsincommonusage: compliance,adherenceandconcordance. Thisdocumentdoesnotinvolveanexhaustivereviewofthe primaryliterature–thishasalreadybeenresearchedto goodeffectandisbeyo...
Complianceisdefinedas:‘Theextenttowhichthepatient’s behaviourmatchestheprescriber’srecommendations.’ However,itsuseisdecliningasitimplieslackofpatient involvement. Adherenceisdefinedas:‘Theextenttowhichthepatient’s behaviourmatchesagreedrecommendationsfromthe prescriber.’Ithasbeenadoptedbymanyasanalternative tocompliance,inanattempttoemphasisethatt...
Werecognisedthatthesethreetermsarenowused interchangeablyandthatthishasgeneratedsomeconfusion. AfterdiscussionwithintheProjectteamandwithourExpert PanelandConsultationGroups,werecommend‘adherence’ asthetermofchoicetodescribepatients’medicinetaking behaviour. Werecognisethatadherenceisnotalwaysa‘goodthing’as aprescriptionmaybeinappropriateornotrefle...
Wegroupedtheliteratureonadherenceintofourcore themes:explainingpatientbehaviour:patient-provider interactions;societalpolicyandpractice;andinterventions. Theseareunderpinnedbycomplexnotionsofthevarious, andsometimesconflicting,thingsweconsidertobe‘good’ aboutprescribingandmedicinetaking.Wepausetoexplore theseissuesinbetweenthepolicyandinterventiont...
Theresearchevidenceshowsthatvariationinadherence cannotbeexplainedbyarangeoffixedfactors,suchasthe typeorseverityofdisease;sociodemographicvariablesor personalitytraits.Adherenceispositivelycorrelatedwith incomewhenthepatientispayingfortreatmentbutnotwith generalsocio-economicstatus.Furthermore,providingclear information,althoughessential,isnotenou...
Ourreviewoftheempiricalevidenceidentifiedsurprisingly fewstudiesthatsystematicallyevaluatethedirecteffectsof theprescribingconsultationonmedicationadherence behaviour.Furtherbasicresearchisneededtoclarifythe effectsoftheconsultationonmedicationadherence,the extenttowhichconsultationskillstrainingcanimprove adherence,andhowdifferentmessagesfromdiffe...
Theimpactofnonadherenceatasocietallevelisprobably substantial,butexistingdataintheUKaretoopoortofully characterisethis,possiblybecause,untilrecently,the managementofadherencehasnotfeaturedstronglyinNHS policy.However,severalcorepolicyinitiativessuchasthe ExpertPatientprogramme,NationalServiceFrameworksand MedicinesUseReviews(MURs)nowplacepatientsel...
Underpinningthiswholereportaretwoquestions–whatis goodprescribingandwhatisgoodmedicinetaking?These questions,incontrasttoquestionsofeffectiveness,have hadlittleindepthexplorationintheliterature,yettheymust beaddressedtoinformpoliciesandpractices.Wefound thesequestionstoberelevantacrosseachofourfour themesanddevotedaseparatechapterofthereport (Chapt...
Theliteratureonadherenceinterventionshasbeenthe subjectofthreemajorsystematicreviewsoverthepastfive years,culminatinginaCochranesystematicreviewin2002. Aspartofourscopingexerciseweextendedthescopeofthe Cochranereviewbyincludingstudiesthatmetthestringent qualitycriteria,butwerenoteligibleforinclusioninthe Cochranereviewbecausetheyhadmeasuredadherenc...
Theevidencefromthisandpreviousreviewsisthat nonadherencetoappropriatelyprescribedmedicinesisa globalhealthproblemofmajorrelevancetotheNHS. Currentlevelsofnonadherenceimplyafailureto addresspatients’needsandpreferencesandrepresent afundamentalinefficiencyinthedeliveryand organisationoftheNHS.Nonadherenceprevents patientsfromgainingaccesstothebesttre...
KeyresearchquestionsmappedontoSDOresearchpriority areas
Inwhatwayscanandshouldpatients’initialchoices andpreferencesbemodified? Inwhatwaysandunderwhatcircumstancesshould patientchoiceformthebasisfordecisionmakingin prescribingandmedicine-taking? Whataremosteffectivewaysofrepresentingevidence forthelikelybenefitsandrisksofmedication? Howcanwetailormedicinesinformationtomatchthe requirementsofindividualpa...
Considerationofvulnerablegroupscutsacrossthe explanatorythemesandisrelevantformostresearch questions,regardlessofwhetherresearchistargetedat explainingindividualbehaviour,investigatingcommunication inhealthcare,societalpolicyandpracticeorevaluating interventions.Workinthisarearequiressystematicreviews oftheavailableliteraturefollowedbyempiricalstud...
✪ This report presents independent research commissioned by the National Institute for Health Research (NIHR). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NHS, the NIHR, the SDO programme or the Department of Health
Reduction, fluctuation, or disappearance of symptoms. Inconvenient or restrictive precautions (eg, no alcohol or cheese) Children are less likely than adults to adhere to a treatment regimen. Adherence is worst with chronic disorders requiring complex, long-term treatment (eg, juvenile diabetes, asthma). Parents may not clearly understand ...
Definition of time periods allowed or considered between refills; can include definition of time period allowed after last refill in the measurement period: Second stage persistence 6 Refill compliance Persistent/Persistence 31,38-43: Later-stage Non-persistence: Failure to have two or more refills over a time period consistent with current use ...
Concept Analysis of Patient Compliance. Walker and Avant’s eight-step concept analysis approach was used in this study (Walker & Avant, 2019). The steps consist of 1) selection of a concept, 2) determination the aim of analysis, 3) identification of all concept uses, 4) determination of defining attributes, 5) identification of a model case ...
If the prescription is appropriate, then this may represent a loss to patients, the healthcare system and society. The costs are both personal and economic. In this guideline 'medicines' is used as a general term to refer to prescribed medicines that are self-administered and includes tablets, syrups, ointments, eyedrops and suppositories.
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Medication Compliance. In subject area: Medicine and Dentistry. Medication adherence is defined as “the process by which patients take their medications as prescribed” and consists of 3 interrelated yet distinct phases: initiation, implementation, and persistence [1,2]. From: Patient Education and Counseling, 2022.
