Key Differences Between Adherence, Compliance and Concordance

By rnapartnersApril 6, 2020Uncategorized

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Many Americans don’t take their medications as prescribed. This may not be news to you. However, the reality of non-adherence to medications is a lot more staggering. According to Annals of Internal Medicine, 50 percent of medications taken for chronic diseases are not taken as prescribed. Additionally, 20 to 30 percent of medication prescriptions are rarely filled. This results in an estimated 125,000 deaths, 10 percent of hospitalizations, and between $100 to $289 billion a year in the US alone. The medical community uses three terms to describe patients and their medication-taking habits. Here are the differences between adherence, compliance and concordance.

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Medication Compliance

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The World Journal of Psychiatry defines compliance as, “The extent to which the patient’s behavior matches the prescriber’s recommendations.” In other words, compliance means the patient obeys the doctor’s instructions. Many see compliance as problematic because the patient passively follows orders regardless of their thoughts or perspectives. Some studies indicate that a patient’s perspective can have an impact on their medication-taking behavior.

Americans have a number of reasons to refuse their medications. These include laziness and forgetfulness. In addition, many simply don’t believe in them. Their reasoning may vary from the preference of taking a more natural approach to watching loved ones undergo ineffective treatment. Furthermore, after stopping their medications, people can create the illusion that they feel healthy while silent killer-conditions such as heart disease and high blood pressure ravage their body. These beliefs ultimately add to America’s unfortunate statistics. Instead of doctors giving patients instructions, they should initiate more of a conversation with their patients.

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Medication Adherence

The World Journal of Psychiatry defines adherence as, “the extent to which a person’s behavior, taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider.” Unlike compliance, adherence is active instead of passive. It opens up a conversation between the doctor and the patient. Instead of only instructions, the provider chooses a treatment after a discussion with the patient.

Medication Concordance

Adherence better establishes an understanding and relationship, but it does not include possible disagreement. Two-way communication exists but doesn’t account for disagreement which solves only half of the problem. Therefore, the third term concordance emerges. Concordance emphasizes an understanding of different points of view between clinician and patient. This gives room to possible disagreement but in the form of open discussion where the patient can air their grievances on their medication beliefs. While providers may disagree with their opinion, their views should be respected.

All three terms are not ideal since their definitions contain the possibility of patients not taking medications for chronic illnesses. However, progress has been made as a result of communication and better doctor-patient perspectives. Patients perspectives are the center of why they refuse to follow taking medication. Therefore, the medical community should recognize the differences between adherence, compliance and concordance.

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Key Differences Between Adherence, Compliance and Concordance

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