De las Cuevas Carlos
Department of Psychiatry, School of Medicine, University of La Laguna, Campus de Ofra s/n, Canary Islands, Spain.
Curr Clin Pharmacol. 2011 May;6(2):74-7. doi: 10.2174/157488411796151110.
Medical terminology is at continuous process of change since the language of medicine needs the rapid incorporation of new terms or changing the existing ones to be in touch with new ideas, concepts and practices. The evolution of the terms "compliance", "adherence" and "concordance" in the field of medicine-taking represents a good example of this. Although these three terms are frequently used interchangeably generating some confusion, compliance, adherence and concordance mean different things and must be used in different ways. Compliance refers to the extent to which patients follow doctors' prescription about medicine taking; adherence refers to the extent to which patients follow through decisions about medicine taking; and concordance refers to the extent to which patients are successfully supported both in decision making partnerships about medicines and in their medicines taking. This terminology evolution may actually be more important than mere semantics since better adherence to a treatment regimen could be achieved through open-ended physician-patient communication, incorporating the beliefs and preferences of the patient in the decision-making process. At present time, concordance could be useful as a normative or aspirational term while compliance and adherence must be the terms used for scientific measurement in medicine-taking field.
医学术语处于不断变化的过程中，因为医学语言需要迅速纳入新术语或改变现有术语，以便与新思想、概念和实践保持同步。“依从性”“坚持性”和“一致性”这几个术语在服药领域的演变就是一个很好的例子。尽管这三个术语经常互换使用，造成了一些混淆，但依从性、坚持性和一致性的含义不同，使用方式也必须有所区别。依从性是指患者遵循医生服药处方的程度；坚持性是指患者贯彻服药决定的程度；而一致性是指患者在药物治疗决策伙伴关系以及服药过程中获得成功支持的程度。这种术语演变可能实际上比单纯的语义更重要，因为通过开放式的医患沟通，将患者的信念和偏好纳入决策过程，可以更好地坚持治疗方案。目前，一致性可以作为一个规范性或理想性的术语，而依从性和坚持性则必须是服药领域科学测量中使用的术语。
