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Summary
This article explores issues surrounding adherence to medication. Terminology associated with the use of medication, most notably the terms compliance, concordance and adherence, are discussed. The article also explores factors that can influence the use of medication and discusses the role of nurses in supporting adherence to treatment.
Keywords
Adherence, compliance, concordance, drug administration, patient-centred care
These keywords are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review. For author and research article guidelines visit the Nursing Standard home page at nursingstandard.rcnpublishing.co.uk. For related articles visit our online archive and search using the keywords.
Aims and intended learning outcomes
This article aims to give nurses and other healthcare professionals an insight into the issues relating to adherence to medication. After reading this article you should be able to:
* Define the terms compliance, concordance and adherence.
* Identify factors that influence adherence to medication.
* Describe the concept of patient-centred care.
* List the steps involved in a medicines-use review.
* Outline the role of nurses in improving adherence to medication.
Introduction
Prescribing medication is one of the most common interventions in health care and there is good evidence to suggest that taking medication in the doses recommended improves health outcomes (Home et al 2005 }. However, there is a plethora of itera ture describing the extent to which patients are consistently found not to take their medications as directed (Snadden 2007).
This phenomenon appears to affect patients with all conditions, including recent NHS priorities such as mental health, cancer, diabetes and respiratory illness (Home et al 2005). Non-adherence to medication is believed to be responsible for considerable ill health and death (Dowell 2007a). It is often a hidden problem, undisclosed by patients and unrecognised by prescribers, but some estimates suggest as many as 80% of patients might be 'non-compliant' in taking their medication (Dunbar-Jacob and Schlenk 2001).
Recent advances in the design and presentation of medicines and the evolution of a more patient-centred approach in health service delivery have not, as yet, solved the problem of non-adherence. There is a pressing need to address non-adherence and develop effective strategies to make the delivery of health care more efficient and responsive to patients' needs...