RT Journal Article
SR Electronic
T1 Physician-Patient Relationship and Medication Compliance: A Primary Care Investigation
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 455
OP 461
DO 10.1370/afm.139
VO 2
IS 5
A1 Ngaire Kerse
A1 Stephen Buetow
A1 Arch G. Mainous III
A1 Gregory Young
A1 Gregor Coster
A1 Bruce Arroll
YR 2004
UL http://www.annfammed.org/content/2/5/455.abstract
AB PURPOSE We assessed the relationship between 4 attributes of the physician-patient relationship and medication compliance. METHODS We conducted a waiting room survey of patients consulting 22 general practitioners in 14 randomly selected practices in Auckland, New Zealand (81% response rate). A total of 370 consecutive patients (75% response rate) completed survey instruments about 4 attributes of the physician-patient relationship. Continuity of care (assessed from use of a usual physician, length of continuity, and perceived importance of continuity) and trust in the physician were ascertained before the consultation. After the consultation the Patient Enablement Index measured the physician’s ability to enable patients in self-care, and concordance between the patient and physician was measured by a 6-item inventory of perceived agreement about the presenting problem and management, were ascertained immediately after the consultation. Compliance with prescribed medication therapy was ascertained by telephone follow-up 4 days after the consultation. RESULTS Overall, 220 patients (61%) received a prescription, and 79% of these patients were taking the medication at follow-up. In a univariate analysis adjusted for clustering, only trust and physician-patient concordance were significantly related to compliance. In analysis further adjusted for health and demographic factors, physician-patient concordance was independently related to compliance (odds ratio = 1.34, 95% confidence interval, 1.04–1.72). CONCLUSIONS Primary care consultations with higher levels of patient-reported physician-patient concordance were associated with one-third greater medication compliance. An emphasis on understanding and facilitating agreement between physician and patient may benefit outcomes in primary care.