2008 issue 4

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Volume 17, issue 4

Review article

Compliance - a relic of the past or a useful term

Karolina Friemann1, Jacek Wciórka1
1. I Klinika Psychiatryczna Instytut Psychiatrii i Neurologii w Warszawie
Postępy Psychiatrii i Neurologii 2008; 17 (4): 365-375
Keywords: compliance, adherence, concordance, shared decision making
Abstract

Objectives. To discuss the meaning and usage of the term "compliance" and of alternative concepts.
Review. The term "compliance " is presented along with related notions such as adherence, cooperation or concordance, discussed with an emphasis on critical opinions about these concepts. The term "compliance " is at present widely criticized due to its evidently paternalistic flavor. As a result of studies on this clinical phenomenon a number of more modern models of the patient-doctor relationship have been proposed. They are overviewed in the paper, with particular attention paid to the "shared decision making" model. Difficulties and challenges associated with redefinition of the doctor's role are outlined.
Conclusions. Compliance has to a large extent failed as a theoretical construct serving to explain and understand patients' behaviors at the stages of treatment initiation and continuation. However, it will most likely remain in further use as a convenient measure of effectiveness of more modern models of the therapeutic relationship.

Address for correspondence:
Lek. Karolina Friemann
I Klinika Psychiatryczna IPiN
al. Sobieskiego 9, 02-957 Warszawa
tel. (22) 4582 532
e-mail: friemann@ipin.edu.pl