Medicines concordance in clinical practice

Neto, Abilio C. de Almeida; Aslani, Parisa

doi:10.1111/j.1365-2125.2008.03241.x

Cited by 10 publications

(12 citation statements)

References 10 publications

(9 reference statements)

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“…'Compliance' , for instance, has been viewed by many as having the negative connotation that patients are subservient to prescribers [41][42][43][44][45]. The term 'concordance' , introduced originally to describe the patient-prescriber relationship, is sometimes incorrectly used as a synonym for 'compliance' [46][47][48][49][50][51][52][53][54][55][56][57]. Most terms used currently do not have a clear or direct translation into different European languages [58].…”

Section: Introductionmentioning

confidence: 99%

A New Taxonomy for Describing and Defining Adherence to Medications

Vrijens

Geest

Hughes

et al. 2011

British Journal of Clinical Pharmacology

229

316

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Interest in patient adherence has increased in recent years, with a growing literature that shows the pervasiveness of poor adherence to appropriately prescribed medications. However, four decades of adherence research has not resulted in uniformity in the terminology used to describe deviations from prescribed therapies. The aim of this review was to propose a new taxonomy, in which adherence to medications is conceptualized, based on behavioural and pharmacological science, and which will support quantifiable parameters. A systematic literature review was performed using MEDLINE, EMBASE, CINAHL, the Cochrane Library and PsycINFO from database inception to 1 April 2009. The objective was to identify the different conceptual approaches to adherence research. Definitions were analyzed according to time and methodological perspectives. A taxonomic approach was subsequently derived, evaluated and discussed with international experts. More than 10 different terms describing medication-taking behaviour were identified through the literature review, often with differing meanings. The conceptual foundation for a new, transparent taxonomy relies on three elements, which make a clear distinction between processes that describe actions through established routines ('Adherence to medications' , 'Management of adherence') and the discipline that studies those processes ('Adherence-related sciences'). 'Adherence to medications' is the process by which patients take their medication as prescribed, further divided into three quantifiable phases: 'Initiation' , 'Implementation' and 'Discontinuation' . In response to the proliferation of ambiguous or unquantifiable terms in the literature on medication adherence, this research has resulted in a new conceptual foundation for a transparent taxonomy. The terms and definitions are focused on promoting consistency and quantification in terminology and methods to aid in the conduct, analysis and interpretation of scientific studies of medication adherence.

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Section: Introductionmentioning

confidence: 99%

A New Taxonomy for Describing and Defining Adherence to Medications

Vrijens

Geest

Hughes

et al. 2011

British Journal of Clinical Pharmacology

229

316

View full text Add to dashboard Cite

show abstract

“…These included adherence and agreement following negotiation, also shared decision‐making. The discussion of a ‘two‐way’ process was mentioned frequently (De Almeida Neto & Aslani , Knapp et al . , Cribb ).…”

Section: Resultsmentioning

confidence: 99%

“…). For example De Almeida Neto and Aslani () explanation for this apparently irrational behaviour is grounded in Brehm's psychological theory of reactance. Reactance suggests that people will do the opposite of what they are advised purely to reassert their right to choice, regardless of the impact of that decision.…”

Section: Resultsmentioning

confidence: 99%

“…De Almeida Neto and Aslani () go on to claim that concordance mitigates reactance. However, at present the impact of this mitigation remains unproved to pharmacists.…”

Section: Resultsmentioning

confidence: 99%

“…The pharmacy literature on attributes of concordance therefore reveals evidence of tension. Whilst there is an authentic concern with the conceptual limits of concordance (Cribb & Entwistle ) this is situated in recognition that patient autonomy is an increasingly important practical aspect of pharmacology (De Almeida Neto & Aslani ) that pharmacists feel unprepared to facilitate (Salter ).…”

Section: Resultsmentioning

confidence: 99%

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