BMJ  2003;327 (11 October), doi:10.1136/bmj.327.7419.0-g

Editor's choice

An extreme failure of concordance

The first 150 words of the full text of this article appear below.

About half of patients with a chronic illness don't take their medicines as prescribed (p 819). They have many reasons, lots of which doctors might regard as "unreasonable," for not doing so. Despite Oliver Wendell Holmes suggesting that if the entire pharmacopoeia were sunk to the bottom of the sea it would be all the better for mankind and all the worse for the fishes, it doesn't seem to be useful for drugs to be invented, researched, described, prescribed, and then not taken. More understanding is needed of what's going on, and this theme issue makes a contribution. In particular, it explores "concordance"—patients and doctors agreeing together about medicines.

My understanding of this elusive concept comes in part from a marvellous book that explores an extreme failure of what might be called "concordance," even though the term is never used in the book. The Spirit Catches You and . . . [Full text of this article]

Richard Smith, editor

(rsmith@bmj.com)


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