This paper assesses the relationship between 4 attributes of the doctor-patient relationship and adherence to medical advice. A waiting room survey was conducted with 22 GPs in 14 randomly selected clinics in Auckland, New Zealand (response rate 81%). A total of 370 consecutive patients (response rate 75%) completed survey instruments on 4 attributes of the doctor-patient relationship. Prior to consultation, continuity of care (assessed by consultation with the doctor, length of continuity and perceived importance of continuity) and trust in the doctor were established. After the consultation, the Patient Enablement Index measured the physician's ability to enable patients to self-care, and patient-physician compliance was measured using a 6-item inventory of perceived agreement on the problem presented and management, which was established immediately after the consultation. Adherence to prescribed medication was confirmed during telephone follow-up 4 days after the consultation. A total of 220 patients (61%) received a prescription and 79% of them took the medication during the follow-up period. In univariate analysis, only patient trust and compliance with the doctor were significantly associated with adherence. In an analysis further adjusted for health and demographic factors, doctor-patient compliance was independently associated with adherence. Primary care consultations with higher levels of doctor-patient concordance reported by patients were associated with one-third higher adherence to medical recommendations. An emphasis on understanding and facilitating doctor-patient agreement may benefit primary care outcomes.
https://onlinelibrary.wiley.com/doi/pdf/10.1034/j.1600-
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