ABSTRACT
Traditionally, the term ‘compliance’ has been used to refer to the degree to which
a patient follows medical advice and complies with treatment recommenda-
tions. A patient who takes his medication is said to be ‘compliant’, while one
who refuses or forgets is called ‘non-compliant’, or described as showing ‘poor
compliance’. It has been suggested that these labels promote a one-sided view of
the consultation process: the doctor offers wise and correct advice and the sen-
sible patient obeys without question. The term ‘adherence’ has been advocated
recently as suggesting a more active role for the patient, while the Royal
Pharmaceutical Society of Great Britain1 advocates the term ‘concordance’ as
promoting the idea of collaboration between patient and prescriber. Ideally, the
consultation process and the devising of treatment recommendations, whether
they involve pharmacological, psychosocial, or other types of treatment, should
be a process of collaborative empiricism where the patient is treated as an equal
partner. There is some empirical evidence that this approach leads to superior
treatment outcome and greater patient satisfaction; more importantly, this
approach respects the autonomy of the patient. How to ensure adherence in
practice is what we will expand on throughout this chapter. It should be noted
that long acting injectable formulations of antipsychotic agents can play a key
role in ensuring adherence in some patients; for details, see Chapter 1.
