"Doing prescribing": how doctors can be more effective

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Abstract
Evidence base Few well conducted, randomised controlled trials of interventions to help patients follow their prescriptions have been done.4 Our article is based on a number of reviews in this field and a recent systematic review of concordance.1 4–6 Changes in terminology in this area have mirrored an increasing rejection of the power relation implicit in the term “to prescribe.” The authority laden term “compliance” gave way to the view that patients “adhered” (or not) to treatment. Recently the term concordance has been used to describe an agreed plan between patient and doctor about the use of treatment—one of the results of a shared decision making process.7 8 Box 1: Concordance tasks Elicit the patient's views on the possibility of having to take medicine Explore those views with the patient Inform the patient of the pros and cons of taking and not taking medicine Involve the patient in the treatment decisions—over time, if necessary, and after reflection Footnotes Competing interests NB was a member of the Concordance Co-ordinating Group of the Royal Pharmaceutical Society, which received funding from Merck Sharp & Dohme, and has been paid for speaking at a conference