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Medicines management for nursing practicePharmacology, patient safety, and procedures$
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Graham Brack, Penny Franklin, and Jill Caldwell

Print publication date: 2013

Print ISBN-13: 9780199697878

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199697878.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 27 October 2021

The Nurse’s Role in Promoting Concordance

The Nurse’s Role in Promoting Concordance

Chapter 9 (p.133) The Nurse’s Role in Promoting Concordance
Medicines management for nursing practice

Graham Brack

Penny Franklin

Jill Caldwell

Oxford University Press

● To support an understanding of the theory of concordance ● Working in partnership with your patient, to relate this knowledge to the achievement of concordance in the consultation process. The NMC code states that when caring for your patient: you must work with others to protect and promote the health and wellbeing of those in your care, their families and carers, and the wider community (NMC, 2008). In the past, nurses would give medicines to patients, and the patients would usually do as they were told and take the medicine without questioning the doctor or health professional. The word used to explain this interaction in the world of medicines management is compliance. This term originates from a traditional biomedical model of care where the patient is viewed as a list of symptoms and it implies that in the act of giving medicines nurses were doing something active to treat the patient’s illness and symptoms. It also implies that the patient was receiving medicines from the nurse; the act of receiving is a passive concept whereby the patient is having something done to them. If they passively followed the instructions that they had been given and took their medicines correctly, then they would get better. The traditional biomedical model of compliance has not proved very effective in terms of patient treatment. If the patient is not given reasons why their treatment is important, or feels that they have not been involved in the decision, the common result is non-compliance. Sometimes this is intentional (the patient decides not to take their medication), and sometimes unintentional (the patient does not know what they need to take, or when). This has cost implications for the National Health Service. If prescribed drugs, often paid for by the NHS, remain unused the patient’s illness may not improve, resulting in the supply of another prescription (or other treatment) that might have been avoided if they had taken the medicine which was initially prescribed. Indeed the World Health Organization identified that less than 50% of patients adhere to their medicines’ regimens (WHO 2003). An American study identified that 33–69% of hospital admissions with ensuing expense to health care delivery are due to poor adherence to medication (Osterberg and Blaschke, 2005).

Keywords:   adherence, compliance, dementia, difficult patients, dysphagia, expert patient programme, health beliefs of patients, learning disability, medication errors, talking labels, visually impaired patients

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