[e-drug] Measuring Patient Compliance? (3)

e-drug
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E-DRUG: Measuring Patient Compliance? (3)
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dear E-druggers,

It's sad to see that we're once again retreating into the use of the term 'compliance.'

I'd thought that there was a general consensus that this term was no longer appropriate, implying passivity and dependence, and obedience to imposed rules.

I believe most now agree that the term adherence is more appropriate, implying empowerment and involvement by the patient in the treatment.

Regards

Chris

Chris W. Green
chrisg@spiritia.or.id
Training & Information, Spiritia Foundation
Jakarta, Indonesia
Tel: +62 (21) 422-5163 Fax: +62 (21) 4287 1866
Web site: <http://spiritia.or.id>
Blog: Adventures with HIV in Indonesia <http://indohiv.blogspot.com/&gt;

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E-DRUG: Measuring Patient Compliance? (4)
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Dear Chris,

Is it patient adherence or patient concordance that implies patient
empowerment and involvement?!

regards

Eman Ahmad
emanaahmed@gmail.com

[please provide profession and affiliation! WB]

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E-DRUG: Measuring Patient Compliance? (5)
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dear E-druggers,

Concordance is a term favoured by many professionals these days, but the term adherence is much more commonly used and easier to explain to patients.

Since "adherence" means something like "stickiness" then it is easy to explain (at least in English) that with respect to medicines, adherence means sticking to the instructions about taking doses at the right times, in the right way, for as long as instructed etc.

regards

Carolyn Green
Independent consultant
cgreenconsult@hotmail.com
skype: cgreenconsult
tel: +44 1273 454032
cell: +44 7733 112 368

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E-DRUG: Measuring Patient Compliance? (6)
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Dear e-Druggers:

I would like to give an opinion based on my experience for a globalised world and that requires a clear and direct communication.

Do not think it is appropriate to once again reinvent the wheel with the "compliance" terminology because everything that happens on this end has already been discovered, and pretend to do science with synonyms do not lead to any clinical advantage.

The "compliance" has been and remains the best term to define the patient's commitment to carry out the instructions of any therapeutic treatment, whether pharmacological or not.

The term "adherence" provides no added value of clinical significance to "compliance", and I argue that the in the same line is "concordance". These additional terms neither helps in the understanding because they can still further increase the confusion for both healthcare professionals as for patients.

In the doctor-patient relationship when seeking compliance, the objective is that the patient gets involved and takes responsibility with the prescribed treatment (including all kinds of meanings). Therefore, the communication must be conceptually clear, exhaustive, direct, and simple to understand. Needless to perceive, interpret, discover, or guess. Therefore in the doctor-patient relationship communication, when every act is therapeutic, has to be transparent and, of mutual trust.

I would advocate leaving any part the medical care in discussion because the dialectical or wording issues when the available concept is clear (“compliance”). Moreover these semantics or other issues related may mislead and anguish the patient, as well for the medical care providers. (In my opinion this is not a help, but a misinformed terminology). The achievement has to be a good communication, unequivocally for all (doctors, patients and health professionals), in favor of good therapeutic results because the patient meets the medical instructions.

regards

Prof. José-Luis Alloza, M.D., Ph.D.
Clinical Pharmacologist
Department of Pharmacology
School of Medicine
The University of Alcalá
E-28871 Alcalá de Henares, Madrid. Spain.
josel.alloza@uah.es

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E-DRUG: No thanks to industry run compliance programmes
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Dear e-Druggers:

Measuring patient compliance should be put in context. For several years, pharmaceutical companies have been investing in new ways to retain their "customers", for example under the guise of programmes designed to help patients follow long-term treatment courses. It is time to put an end to this dangerous trend.

A major challenge for any company is to find ways to maintain customer loyalty. They are well aware that it is far less expensive to keep an existing customer than to find a new one. The pharmaceutical industry estimates that 30 billion dollars in sales are lost each year (out of a total of 600 billion dollars in global sales), because patients interrupt their treatments.

Pharmaceutical companies¹ intrusion into patient "coaching" started in the United States, where drugs are more heavily commercialized than in Europe. "Medication compliance programmes", which are simply a sophisticated form of advertising, are flourishing. Such programmes are starting to enter France by the back door.

More at http://english.prescrire.org/bin/m2/index.php

regards

Christophe Kopp
Prescrire staff member
http://english.prescrire.org/