Making life a little easier
with your medicines Concordance – what’s it all about? Senior pharmacist Neil Hamilton explains the latest techniques to help PH patients take their prescribed medication.
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oncordance, and sometimes adherence are terms that have become more commonplace health language in recent years, often referring to patients taking their prescribed medication correctly. Previously people may have used the term compliance but this has rather fallen out of favour. Concordance is defined in one of the largest medical dictionaries as being; A negotiated, shared agreement between clinician and patient concerning treatment regimen(s), outcomes, and behaviours; a more cooperative relationship than those based on issues of compliance and noncompliance. The word itself has its roots in Late Middle English: from old French (concordant) and from medieval Latin (concordantia), both meaning ‘being of one mind'. It is the sense of a shared agreement which explains why the phrase “compliance” has become less popular, as we move away from the idea that Doctors tell patients what to do and patients have no say in their own management. This old way of thinking is commonly being replaced by patients and healthcare professionals agreeing on the best plan. Whilst the teams at
SPRING 2015 emphasis 38
the specialist centres have the knowledge and clinical training, nobody knows you like you do, and the best idea on paper may not be realistic for everyone. With this in mind, one of the most obvious forms of nonconcordance is noted when patients fail to take their medicines exactly as prescribed. There is little research data available specific to Pulmonary Hypertension , but in other long-term conditions, concordance has been found as low as 50%. This means that only half of all patients involved in the project took their treatments exactly as prescribed. This seems surprisingly low, and it would be very interesting to understand what the figure is in the UK and even more helpful to find out why it is not close to 100%. I know that the PHA is doing some work on this so watch this space… The specialist treatments for PH are expensive and whilst paying for this should never be your concern, the NHS would much rather be paying for a treatment that you will take as prescribed rather than one for which your doses are often late or worse still, missed. With this in mind, there are several options available to patients who, for any reason, are serially ‘forgetful’ (as opposed to those who consciously decide to take their medicines different to how it is prescribed).
