Search results
The terms compliance and adherence are interchangeable among healthcare practitioners, but there are numerous differences between the two terms. Adherence involves patients actively choosing to follow the prescribed treatments as they are responsible for their own health, whereas compliance usually indicates passive actions whereby the patients follow a list of orders from the physician.
Non‑adherence may limit the benefits of medicines, resulting in lack of improvement, or deterioration, in health. The economic costs are not limited to wasted medicines but also include the knock‑on costs arising from increased demands for healthcare if health deteriorates. Non‑adherence should not be seen as the patient's problem.
- 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
Background. The National Institute for Health and Clinical Excellence (‘NICE’ or ‘the Institute’) has commissioned the National Collaborating Centre for Primary Care to develop a clinical guideline on medicines concordance for use in the NHS in England and Wales. This follows referral of the topic by the Department of Health (see appendix).
Mar 8, 1997 · At long last the “compliance problem” may be getting a new name and, with it, a new view of the patient's role in the doctor-patient relationship. A report published this week by the Royal Pharmaceutical Society of Great Britain's working party on medicine taking recommends that “concordance” should replace the term “compliance.”1 Although substitute terms have been suggested and ...
- Patricia Dolan Mullen
- 1997
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."
People also ask
What is medication compliance?
What does compliance mean?
How does non adherence affect health?
What is the difference between adherence and compliance?
Does compliance lead to desirable and undesirable consequences?
What is patient compliance to treatment?
Compliance was defined by Sackett and Haynes (1976) as “the extent to which a person's behavior in terms of taking medications, following diets or executing lifestyle changes coincides with medical or health advice.”[24,28,29] However, not all researchers agreed with this definition used in their research. McGann (1999) quoted the definition, but continues it with this expression, “this ...
