Adherence And Concordance

Question 1

Define concordance

Answer 1

Concordance refers to the nature of interaction between the patient and the prescriber. This should be a non judgemental partnership in which a patient has the right to refuse

Question 2

Define adherence

Answer 2

Adherence refers to the extent to which a patients actions match the general recommendations. Poor adherence can be intentional or unintentional

Question 3

Quote NICE guidelines on medicine adherence

Answer 3

NICE (2009) Medicine adherence: Involving patients in decisions about prescribed medicines and supporting adherence

Question 4

What are the 10 key principles highlighted in the NICE guidelines?

Answer 4

• adapt consultation style (their way)
• Establish best communication style
• Level of decision making
• Capacity
• Patients right to decide
• Acknowledge concerns and beliefs
• offer info free from jargon
• non adherence is common - be non judgemental
• Adherence can be improved but no one size fits all
• Review regularly - knowledge and understanding may change

Question 5

Expertise of patient and clinician should be shared…

Answer 5

Clinicians expertise:
- Diagnosis
- Disease aetiology
- Prognosis
- treatment options
- outcome probabilities

Patients expertise:
- experience of illness
- social circumstances
- attitude to risk
- Values
- Preferences