From The Editorial Director: Reaching Concordance

Each year, thousands of Americans are prescribed medications by their physicians. Some of these drugs are designed to improve quality of life, while others are crucial for maintaining life.

As we know, the typical scenario involves an office visit with an examination by the physician, then a written prescription. The final steps involve the purchase of the drug by the patient, then the patient taking the drug as directed. While this progression seems logical, in the real world these last two steps are often not accomplished. In the medical community, patient compliance with drug regimens is a serious concern. For example, researchers reported that in asthmatic patients compliance to inhaled corticosteroids and other preventive asthma therapies is often less than 50%.1 The medical community developed the concept of concordance to deal with this problem. Concordance implies a more give and take relationship than compliance-one in which the physician strives to increase prescription use by enhancing convenience.

In the oral health community, we are also troubled by patient compliance. Our concern ranges from recommending therapeutic procedures to offering advice to patients on appropriate self-care products. However, if we implement the concordance model from the medical community, perhaps we would have greater success, especially in the area of oral hygiene product recommendations. We have all experienced frustration after recommending specific, individualized regimens to patients, only to learn at their next recare appointment that they haven’t purchased the products we’ve suggested. As a result, their oral health has suffered. A simple way to avoid such situations is to have products readily available for patients to take with them. After a recare appointment, patients are probably more motivated to perform better oral hygiene, especially when the dental hygienist has provided instructions on proper use. Yet, we have them leave the office empty-handed, merely with the encouragement to buy a device or product at the nearest store.

Each office should determine its best policy for providing products, whether that entails selling the products separately or including them in treatment fees. Ultimately, our goal is to help patients perform the best oral hygiene possible. So let’s think concordance, not compliance in order to help our patients reach their oral hygiene goals.

—Jill Rethman, RDH, BA, editorial director
jrethman@belmontpublications.com

References

1. Schaffer SD, Tian L. Promoting adherence: effects of theory-based asthma education. Clin Nurs Res. 2004;13:69-89.

From Dimensions of Dental Hygiene. December 2004;2(12):4.