What’s in a name? Compliance, adherence and concordance in chronic psychiatric disorders

Core Tip

Core tip: Medication-taking in chronic psychiatric illnesses has been described using three seemingly related terms. Compliance, the degree to which patients follow the clinicians’ treatment-recommendations, has adverse implications for patient autonomy and the clinician-patient relationship. Adherence, used as a replacement for compliance, puts the therapeutic relationship in its proper perspective, by focusing on patient participation in deciding treatment choices, and being non-judgmental about patients’ medication-taking behaviour. Concordance emphasizes a therapeutic relationship, which facilitates clinicians’ and patients’ views on treatment, and supports an informed choice of treatment by patients. The evolution of these terms represents genuine progress in understanding patients’ perceptions of medication-taking.