Edinburgh Napier University

  Adherence based medicines interventions are known to be of limited success. Concordance offers an ethically superior approach as it is grounded in the principle of collaboration. However, the application of concordance in practice appears inconsistent. This paper considers the extent to which this is a function of the different usage of the concept of concordance in nursing, general medicine, psychiatry and pharmacy.
AIM This paper is a report of an analysis of the concept of concordance
METHOD DESIGN Roger’s evolutionary method of concept analysis. Relevant databases were searched for publications between 2000–2012 with combinations of key words including concord*, adherence, compliance, medic*, psychiatr*, pharm*, nurs*.
METHOD REVIEW A representative sample of 500 papers was identified from the source disciplines. Exclusion criteria limited the final sample to 60 papers in total, entailing 15 per discipline. Each discipline’s papers were analysed for referents, antecedents, consequences, attributes and surrogates. The team then worked together to cross check these interpretations.
RESULTS There was minimal agreement between the disciplines, suggesting each discipline practised a different conceptualisation of concordance. The main point of agreement was that better research was required to articulate the scope and value of partnership working.
OUTCOMES AND SIGNIFICANCE The presentation details the clinical implications of these findings and clarifies a distinct and currently missing research agenda.

TRANSLATION TO FURTHER ACTION We describe an ongoing novel programme of research designed to construct empirical evidence of the impact of different models of collaboration on the clinical consultation and subsequent outcomes (Snowden, 2013).