From compliance to concordance in diabetes.

Compliance is a key concept in health care and affects all areas of health care including diabetes. Non-compliance has previously been a label attached to many patients without much thought having been given to the causes of poor compliance. Over the last few decades there has been a large volume of research focusing on compliance that has exposed the multitude of factors affecting compliance. Even the definition is not clear cut and so comparability between studies is not without difficulties. A better understanding of the factors affecting compliance, including the doctor/patient relationship, has allowed the evolution of "concordance". Concordance views the patient as being the equal of the healthcare provider and as having a right to make informed decisions. In a condition such as diabetes, which has many potential long term complications, it is vital that concordance is embraced in the healthcare system in order to improve care.