Discordance Between Drug Adherence as Reported by Patients and Drug Importance as Assessed by Physicians.
Among patients on long-term medical therapy, we compared (1) patient and physician assessments of drug adherence and of drug importance and (2) drug adherence reported by patients with drug importance as assessed by their physicians.



We recruited to the study patients receiving at least 1 long-term drug treatment from both hospital and ambulatory settings in France. We compared drug adherence reported by patients and drug importance assessed by physicians using Spearman correlation coefficients. Reasons for nonadherence were collected with open-ended questions and classified as intentional or unintentional.



Between April and August 2014, we recruited 128 patients taking 498 drugs. Patients and physicians showed only weak agreement in their assessments of drug adherence (r = -0.25; 95% CI, -0.37 to -0.11) and drug importance (r = 0.07; 95% CI, 0.00 to 0.13). We did not find any correlation between physician-assessed drug importance and patient-reported drug adherence (r = -0.04; 95% CI, -0.14 to 0.06). In all, 94 (18.9%) of the drugs that physicians considered important were not correctly taken by patients. Patients intentionally did not adhere to 26 (48.1%) of the drugs for which they reported reasons for nonadherence.



We found substantial discordance between patient and physician evaluations of drug adherence and drug importance. Nearly 20% of drugs considered important by physicians were not correctly taken by patients. These findings highlight the need for better patient-physician collaboration in drug treatment.
Department of General Medicine, Paris Descartes University, Paris, France METHODS Team, INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Centre, France.
Stéphanie
S
Sidorkiewicz
METHODS Team, INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Centre, France Department of General Medicine, Paris Diderot University, Paris, France thi.tran-viet@htd.aphp.fr.
Viet-Thi
VT
Tran
Department of General Medicine, Paris Diderot University, Paris, France.
Cécile
C
Cousyn
METHODS Team, INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Centre, France.
Elodie
E
Perrodeau
METHODS Team, INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Centre, France French Cochrane Centre, Paris, France Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York.
Philippe
P
Ravaud
D000328:Adult; D000368:Aged; D005260:Female; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D057566:Self Report; D016903:Drug Monitoring
drug prescription; drug therapy; medication adherence; physician-patient relation; practice-based research; primary care