Strategies to Improve Drug Adherence

Ulrich Laufs; Volker Rettig-Ewen; Michael Böhm


Eur Heart J. 2011;32(3):264-268. 

In This Article


Drug compliance is defined as the extent to which patients follow medical instructions.[17] Today, the term 'compliance' is used less frequently because it implies that only the patients is responsible for the medical treatment. The term 'adherence' has now replaced 'compliance', because it reflects a less paternalistic physician–patient relationship, and includes the responsibility of the caregivers. Adherence has been defined as 'the active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of behaviour to produce a therapeutic result'.[4] Some patients may never start treatment and this type of non-adherence has been named non-acceptance. Medication adherence also includes the concept of persistence taking into account the willingness to take a prescribed medication throughout the overall duration of drug therapy.[4] The degree of accordance of therapeutic goals of patient and therapist is defined as 'concordance'. The definition of 'concordance' has changed over time from one which focused on the consultation process, in which doctor and patient agree on therapeutic decisions that incorporate their respective views, to a wider concept which stretches from prescribing communication to patient support in medicine taking.[18] For practical reasons, many studies on this topic report the percentage of doses taken during a time period, however, this does not distinguish between individuals that have executed the regimen well but quit compared with individuals that took only part of the doses but continued over the whole observation period.


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