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Patient compliance consists of two words: patient and compliance. “Patient” refers to an individual undergoing medical care, particularly at a hospital (Oxford Learner's Dictionaries, 2023a). “Compliance” derives from the Latin word complire, meaning to fill up and, thus, carry out a behavior, transaction, or process and keep a commitment.
- 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
Average rates of compliance in patients with chronic illnesses are from 0 to 100%.[5,6,7,8,9] In Iran, the rate of compliance has been reported to be between 12.7 and 86.3%.[10,11,12,13] Promotion of compliance is one way to prevent worrisome consequences to enhance patients’ quality of life and concurrently to reduce costs on medical treatment.
- Forough Rafii, Naima Seyed Fatemi, Ella Danielson, Christina Melin Johansson, Mahnaz Modanloo
- Mar-Apr 2014
- 2014
In a retrospective cohort study of 381,422 patients using an integrated pharmacy and medical claims database, higher MPR was associated with reductions in subsequent total health care costs and cardiovascular disease-related hospitalizations. 42 Another retrospective claims-based study of 1,705 patients with diabetes and hyperlipidemia showed that adherence decreased all-cause medical costs by ...
Apr 28, 2023 · Adherence is an active process in which a patient takes responsibility for their overall well-being, while compliance is a passive behavior in which a patient is follow-ing a list of recommendations from the doctor. Adherence puts the patient’s interests above physicians' interests while making sure that the patient follows recommendations ...
Feb 10, 2015 · Box 1: Impact of long term conditions. Around half of the population in the US 2 and 40% in the UK 3 have a long term condition. Multimorbidity is increasing—65% of people aged 65-84 in the UK have two or more conditions, rising to 82% of those ≥85. However most people with multimorbidity are younger than 65 3.
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Oct 2, 2020 · Adherence is defined as the extent to which the individual's behaviour or actions match the recommendations agreed with their health professional (National Institute for Health and Care Excellence (NICE), 2009). Non-adherence is a major barrier to the effective delivery of healthcare, and it is estimated that adherence to treatments for long-term conditions averages 50% in developed countries ...
