Compliance a broken concept

BMJ 1997; 314 doi: (Published 08 March 1997) Cite this as: BMJ 1997;314:0

Compliance, says Chambers Dictionary, means “yielding, compliance, submission.” Compliant-or perhaps even good-patients “submit” to the prescriptions of doctors and “take their medicine”–a phrase that also means accepting punishment. The dictionary is telling us that compliance is a word with negative connections, and papers in this week's BMJ urge us to rethink the concept.

Whatever we call the problem it matters. Only about half of patients with chronic disease take their medicines in therapeutically effective doses (p 747); and the commonest cause of failure of kidney …

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