Compliance or concordance?

Abstract

The discussion over the correct term to describe effective treatment taking continues, but may prove to be a distraction from the real issue which is that uptake and continuation of hormone replacement therapy remain low. "Compliance" continues to be widely used to describe treatment problems, despite criticisms of its implied doctor/patient relationship, but has the benefit of being familiar. Compliance is also poor with other treatments, such as antihypertensives. Numerous issues affect compliance with hormone replacement therapy: lack of information, attitude and gender of the doctor, side effects, lack of symptom control, dislike of bleeding and fear of long term consequences. Nurses and pharmacists can help doctors in providing an integrated health care team. More research is required to address the process of decision making by women as to whether they take hormone replacement therapy or not.