The Pharmaceutical Journal
Vol 271 No 7271 p538
18 October 2003

This article
Reprint
Photocopy

News summary

Related websites
BMJ (bmj.com)

BMJ tackles concordance issues

Last week's BMJ focused on concordance. Some of the subjects examined included initiating preventive treatment, attitudes towards drugs use in chronic conditions and improving compliance.

Preventive treatment A survey in Liverpool assessed attitudes towards initiating a treatment to prevent a heart attack. Lay people wanted to make decisions themselves and the clinicians supported this.

Many people were averse to taking drugs unless absolutely necessary and preferred lifestyle changes to medication. Other factors mentioned by participants included side effects of the preventive treatment and its cost. “Guidelines should reflect the importance of true dialogue between clinicians and patients before embarking on lifelong preventive treatment,” the researchers conclude (BMJ 2003;327:841).

Chronic conditions Attitudes towards drug use among middle-aged people with multiple chronic conditions found an aversion to taking medicines, despite respondents acknowledging that they depended on them to live as normal a life as possible. One tension was between adopting a regular regimen for one drug yet a more flexible approach to another. Patients made variations in regimens to control symptoms or in order to undertake particular tasks or social roles. The researchers comment that in order to optimise concordance, people’s experiences of drug use in chronic conditions needs to be understood (ibid, p837).

Compliance A particular form of counselling called “compliance therapy” was found to be no more effective at improving compliance than non-specific counselling in patients with schizophrenia, researchers report. Compliance therapy is a cognitive behaviour intervention using techniques such as motivational skills. However, it gave no advantages over non-specific counselling in terms of patients’ adherence to treatment, attitudes to medication, symptoms or quality of life (ibid, p834).