While the practice nurse is reviewing Ronnie’s notes, he sits in the waiting room, worrying about how the appointment will go.
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Ronnie’s Barriers to Concordance
NHS Problems (Medicines/reconcilliation): Last time I was in the hospital they mixed up my tablets and I nearly passed out in the bookies! It seems that every time I go to see the nurse or doctor, I get a new tablet to take… they’re always adding to them and they never take any away!
Forgetfulness: I forgot to take today’s tablets this morning… I wonder if the nurse will be able to tell if I’ve taken them or not? I also fell asleep watching the telly last night – I can’t even remember when I last took them!
Social isolation: I used to be better at taking my tablets when I was still married and my wife was around to help me but I’m divorced now, and it’s not like I have kids worrying about my health either!
Medication supply: How often have I gone to pick up my prescription and it hasn’t been ready? That’s happened to me countless times! And see since they closed the local chemist, I now need to get the bus all the way into town now to get my tablets.
Physical problems: Those tablets are very fiddly, I can hardly get them out of the packet! I have difficulty swallowing them as well – they just make me feel sick.
Lack of understanding: I feel fine, so whats the point in taking them? I mean, loads of my pals have high blood pressure and it’s not like it’s a matter of life or death for them is it?
Pulse point
Strategies to aid concordance:
There is a lack of direct evidence around this, however, it may be pragmatic to consider:
1. Simplifying dosing regimes
2. Encouraging Ronnie to record medicines taking
3. Social prescribing to minimise barriers to concordance
Page last reviewed: 17 Sep 2020
