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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 ...
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At long last the “compliance problem” may be getting a new...
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4 days ago · Persuade, coerce. Discuss, negotiate, motivate. Resistance is not tolerated. Resistance provides information for adaptation. Compliance can be seen as a more straightforward, short-term measure of a patient's actions, while adherence is a comprehensive approach that includes understanding and willingness.
- 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
Patients’ compliance to treatment is an important indicator for evaluating the successful management in chronic illnesses. Despite the fact an applicable definition of compliance is required to suitable intervention and research, this concept is not clear and there is no consensus concerning its meaning, definition, and measurement. The aim ...
- Forough Rafii, Naima Seyed Fatemi, Ella Danielson, Christina Melin Johansson, Mahnaz Modanloo
- Mar-Apr 2014
- 2014
The new definition of compliance given in this concept analysis provides clarity and directions for future inquiry and nursing practice. The findings are beneficial for nurses in constructing a tool to predict compliance behavior for a given patient and condition, including a relationship model that focuses on the role of healthcare providers and patients.
Adherence and compliance are two terms often used in healthcare to describe a patient's behavior towards following medical advice or treatment plans. Adherence refers to the extent to which a patient follows the recommended course of action, including taking medications as prescribed, attending appointments, and making necessary lifestyle changes.
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So, although ‘compliance’ and ‘concordance’ are sometimes useful, I generally prefer the term ‘adherence’, which is being increasingly used. It comes from the Latin word adhaerere, which means to cling to, keep close, or remain constant. In the OED it is defined as ‘Persistence in a practice or tenet; steady observance or ...
