ABSTRACT
Traditionally, the term compliance has been used to refer to the degree
to which a patient follows medical advice and complies with treatment
recommendations. Patients who take their tablets are said to be comp-
liant, while those who refuse or forget are called non-compliant, or are
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 sensible 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 Britain (1997) suggest the term concordance as promot-
ing the idea of negotiation 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. Not only is there empirical evid-
ence that this approach leads to superior treatment outcome and greater
patient satisfaction, but it respects the autonomy of the patient. How to
improve adherence in practice is what will be expanded on throughout
this chapter.
