The Pharmaceutical Journal
Vol 271 No 7272 p578
25 October 2003

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Letters to the Editor

Concordance

Maintain an attitude of respect

From Dr P. Bissell

I was heartened to read Irene Gummerson’s letter (PJ, 18 October, p543) regarding my article (PDF 65K) in the PJ devoted to concordance (11 October, p498). Although I am sure that Mrs D’s treatment could be improved (Mrs D was the individual I was writing about), one of my points was that it is the delineation of patients into “successes” and “failures” in the first place that is the problem. I think that health professionals who are interested in concordance need to get away from making judgements about patients as “successes” or “failures” on the basis of their ability to comply. The important point — if establishing partnerships with patients is to have any real meaning — is to maintain an attitude of respect for the patient, even if he or she does not do as health professionals suggest.

Paul Bissell
Lecturer in Social Pharmacy
University of Nottingham

Antidepressants are not “a crutch”

From Ms R. Greer

I read your concordance feature, in particular the paper (PDF 100K) by Grime and Pollock (PJ, 11 October, p516), with interest having had personal experience of depression treated with antidepressants.

Patients receiving such treatment are commonly told by health professionals that the medicines are “only a crutch” and that the patients themselves hold the key to recovery. This denigrates antidepressants to the extent that the patient feels obliged to do without them as soon as recovery begins. However, on being advised of this, health professionals who prescribe antidepressants vehemently object to the cessation of their use. The patient is left confused and has to fall back on instinct or common sense, in deciding whether or not to continue taking the medicine.

If health professionals would desist from using the term “a crutch” and instead use “an aid to recovery”, perhaps life would be easier for depressed patients and they would stay on their medication for longer with confidence.

Rita Greer
Liss, Hampshire

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