Patient adherence, compliance, and concordance

Question 1

What is compliance?

Answer 1

‘The extent to which the patient’s
behaviour matches the prescriber’s
recommendations.’

Question 2

What is adherence?

Answer 2

‘The extent to which the patient’s behaviour
matches agreed recommendations from the prescriber.’

Question 3

What is Intentional and non-intentional non-adherence?

Answer 3

Intentional: the patient decides not to follow the treatment recommendations
Unintentional: the patient wants to follow the treatment recommendations but has practical problems

Question 4

What needs to be explored to make a non-judgemental decision on adherence?

Answer 4

What will happen if they don’t take the medicine.
Non-pharmacological alternatives.
Reducing or stopping long-term medicines.
Fitting medicines into their routine.
Choosing between medicines.

Question 5

How to improve adherence?

Answer 5

• To involve patients in decisions about prescribed medicines and to support adherence – patient centred care.
• Education on their disease
• Simplify drug regimes
• Guidance on device use
• Address problems with physical difficulty
• Compliance aids

Question 6

What are the main points of concordance?

Answer 6

The level of information given to patients.
Side-effects.
The costs of medication.
The effect on lifestyle.

Question 7

Concordance in children

Answer 7

• Parents mainly responsible for administration
• Influenced by taste, formulation, appearance, ease of administration
• within child’s daily routine
• collaboration with child/parent

Question 8

Concordance in elderly

Answer 8

• effective communication
• Simple regimens
• Reminder charts
• Monitor plasma drug levels?
• Review meds regularly
• Consider poor practical difficulties
• Awareness of problems of polypharmacy

Question 9

Main goals of medicines optimisation

Answer 9

• improve their outcomes;
• take their medicines correctly;
• avoid taking unnecessary medicines;
• reduce wastage of medicines;
• improve medicines safety.