Therapy compliance, concordance, adherence… what’s in a name?

Approximately half of the patients takes prescribed medicines wrongly or not at all.

That is a shame, because a lot can be gained with better use of medication. More compliance to therapy, that is to say the patient’s behaviour in accordance with the doctor’s prescribed advice, would not only result in better quality of life and a higher life expectancy, but also means a considerable saving on health care costs.

Different terms are used interchangeably, but each time a slightly different aspect is emphasized:

• Adherence: the extent to which the patient complies with agreements.
• Compliance:  the extent to which the patient follows the recommendations of the prescriber.
• Concordance (or agreement): the extent to which the patient and practitioner agree on the treatment.
• Persistence: the extent to which the patient persists in the use of medicines.

It is normally in the interest of the patient that he/she continues to follow his/her prescribed therapy. If the patient does not do that, it may be to the detriment of his/her health. Because the prescribed treatment is not applied as prescribed, the patient does not get the best possible quality of treatment. For example, he/she runs a greater risk of having a stroke or heart attack without even realising it. In addition, there are medicines with increased risks if taken irregularly. There is even a risk to the environment if pathogens become resistant because the necessary antibiotics are taken in a too low dosage.

There are all kinds of interventions to improve therapy compliance: simplifying the treatment or dosing schedule, good and clear communication from the treating physician, thorough follow-up by the pharmacist, and providing all kinds of tools (medication boxes, schedules, apps, alerts …).

Nevertheless, gradually more people are becoming aware that the acceptance of your disease and treatment are very important conditions for compliance. The emphasis is therefore more on motivating and guiding the patient than on complying with prescriptions. In this context, we see that counselling programs through nurses who visit patients at home pays off. In addition to the practical aspects of administering, the nurse can also inform and coach patients, guide them through the process of acceptance and thus achieve good therapy compliance. This personal approach in an atmosphere of trust works well.

The patient programs that run through Novellas Healthcare are a good example of this approach. All nurses from Novellas Healthcare deserve a compliment for their beautiful work!

The management standard ISO 9001 requires organizations to describe, analyse, measure and continuously improve their processes. This allows all stakeholders to get a better understanding of their role, and insight in how they contribute to the success of their organization, which in turn increases internal quality awareness.

Audit ISO 9001

Audits by independent certification bodies determine whether you meet all the requirements of the standard. You can also organize internal audits before and after those official audits to keep your finger on the pulse.

We have been describing all our processes for a little over a month. Anke Verheyen is our project manager who ensures that everything runs smoothly. An external partner, Kris Bulens, who has a lot of experience with the ISO standard certification, also assists us. He guides us through the process and gives us advice. We hope to achieve ISO 9001 by January 2021. If you want to have a visual look at the ISO standard, watch this video. Although this video dates back a couple of years, the basis is still valid.