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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.
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.
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
outcomes in terms of morbidity or mortality for the patient and to an increased economic burden on the healthcare system. c) The terminology used when discussing medication-taking behaviours is complex, with three commonly used definitions. • Compliance – ‘the extent to which the patient’s behaviour matches the
Oct 9, 2013 · Abstract. It is well known that patient adherence to appropriately prescribed medications is essential for treatment efficacy and positive therapeutic outcomes. It is also understood that patients who are prescribed medications do not necessarily take them as prescribed. Indeed, variation in patients' medication-taking is an age old conundrum ...
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Apr 11, 2023 · Thus, the World Health Organization agreed upon the following definition of adherence: “the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider” (World Health Organization, 2003, pp. 3–4).
