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Compliance, Adherence, Concordance – What’s in a Name?
  1. Richard Metcalfe
  1. Consultant Neurologist, Institute of Neurological Sciences, Southern General Hospital, Glasgow G51 4TF; E-mail: r.metcalfe{at}


In the UK, about £100M each year, enough to build a sizeable hospital, is wasted on medication prescribed, dispensed but returned to pharmacies. And this figure, though large, does not include any unused medication disposed of in other ways. Reducing this waste makes sense but how can we achieve it? As anyone who has tried to complete a course of antibiotics knows, it isn’t easy to take medication consistently, particularly if you aren’t feeling ill anymore and especially if adverse effects are troublesome. The factors influencing consumer behaviour include the balance between perceived benefit and risk, age (the older the more compliant), and the complexity of the prescribing regime. Some diseases, asthma for example, seem to be associated with particularly high rates of non-compliance.

We do however, need to consider another potential problem, namely how well we can identify and work with patient beliefs and cover the agendas of our

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