Concordance: A new way of thinking about "compliance"?

Abstract

Compliance and non-compliance: The simple definition of non-compliance is a'failure to follow the doctors "orders" or instructions.' However this concept has been challenged as it has negative echoes of 'blaming the patient'r (cf. William Ryan's seminal work'Blaming theVictim'2 and the tension between patient autonomy vs patriarchy3.) Compliance traditionally makes an assumption that the patient's role is passive while the prescriber's view is rational, evidence' based, and superior to the beliefs and wishes of patient. lt is estimated that 1/3 to 1/2 of all patients make errors with their medications for multiple reasonss. A few traditional 'non-compliance factors' are described in Table 1. It is worth noting that'doctor factors' in non-compliance are conspicuous by their absence in this particular summary - reflecting the prevailing view that healthworkers have only a limited responsibility in terms of compliance.