Concordance
From Ganfyd
Medication Concordance is a partnership approach between a prescriber and patient to establish optimal appropriate treatment usimg medications for a patient.1
Obtaining better compliance with medication is only one goal. Concordance involves:
- Appropriate education of patients to allow informed decisions
- Patient involvement in the treatment decision
- Health professional support, including regular review and effective communication between the professionals advising the patient.
A danger of concordance is that the coercion implied in the concept of compliance remains but is concealed.2
Some reasons why patients do not take medications are:
- Process issues
- Cost
- Of medication
- Of health advice
- Of indirect processes - eg travel
- Practical
- Renewing scripts. The more often this must be done, monthly rather than 2 or 3 monthly, the more opportuities for every one to get it wrong, whcih can over-balance any savings from reduced stocks of medicines held by people when they die or have their treatment changed.
- Access to pharmacy
- Opening containers
- Remembering to take medicines
- Cost
- Lack of knowledge
- insufficient information about their condition
- importance of treatment
- Adverse effects
- Commonest reason for non compliance
- Some may be transient, and if patient forewarned this can increase concordance
- Interference with their own preferences
- Committants to others/work
- Inconvenience
- Beliefs about the medicine, or medicines in general
- Many will believe that a herbal remedy is safer or more effective
- Medicines are harmful
- Medicines are addictive
- Medicines should cure and otherwise are pointless
- Medicine benefits wear off over time
There is a large evidenced based literature on this area of medicial practice.
