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"Compliance" to "concordance": a critical view.
1Department of English, University of British Columbia, Vancouver, BC, V6T 1Z1, Canada. jsegal@interchange.ubc.ca
The Journal of Medical Humanities
|April 28, 2007
Summary
Concordance, a model for shared patient-physician decision-making, is critically examined. Despite aiming to replace patient compliance, research suggests concordance may still harbor compliance ideologies, highlighting commercial influences on medication use.
Area of Science:
- Health policy and management
- Patient-physician communication
- Pharmaceutical marketing
Background:
- The concept of 'concordance' emerged as a partnership model for shared physician-patient decision-making.
- It aimed to replace the traditional 'compliance' model, where patients passively follow medical advice.
Purpose of the Study:
- To critically evaluate the concordance model of shared decision-making.
- To investigate the underlying ideology and potential contradictions within concordance literature and implementation.
- To explore the influence of commercial factors on patient medication adherence.
Main Methods:
- Critical analysis of existing literature on the concordance model.
- Examination of materials from the Medicines Partnership, a UK-based implementation arm.
- Exploration of the relationship between compliance, commercial interests, and patient drug acquisition/usage.
Main Results:
- The literature on concordance contains inherent contradictions.
- The concordance model may inadvertently perpetuate an ideology of compliance.
- Commercial factors significantly influence how patients are persuaded to use medications.
Conclusions:
- The concordance model, despite its intentions, may not fully resolve issues of patient adherence.
- A deeper understanding of the interplay between commercial interests and patient medication-taking behavior is crucial.
- Future improvements in patient medication use require addressing the commercial persuasion tactics influencing healthcare choices.
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