Adherence vs. Compliance vs. Persistence: A Breakdown^1-3

The key difference between adherence and compliance is that adherence requires a patient to be an active participant in their care, engage in effective communication with their healthcare provider, and agree to recommendations through a shared decision-making process; adherence reflects the extent to which a patient’s behavior matches the agreed-upon prescribed treatment. Compliance, meanwhile, suggest a more passive patient role, with the patient just following medical orders.

Initiation/primary adherence describes whether or not the patient filled and started the prescription(s)

Execution/secondary adherence reflects whether or not the patient’s real-world drug-taking behavior is consistent with the prescribed drug dosing regimen

Medication persistence corresponds to the time frame of continuous therapy in which the patient first started the therapy (fills/refills prescription) to when they discontinue that therapy

Concordance is the degree to which the patient’s expertise, beliefs, and opinions were communicated and taken into account when determining treatment recommendations as part of a balanced therapeutic alliance between the patient and provider