Pharmacists: Label with care

摘要

In the interests of being politically correct it is appropriate to regularly reconsider the language we use in order to ensure it is in line with current trends and beliefs and is unlikely to offend. Perhaps it is because I'm a pharmacist that I have traditionally been more than happy to jump at an opportunity to use new labels. Increasingly, however, I'm realising that there is a point at which producing new labels may not be necessary and could in certain circumstances actually be detrimental. My first experience of labelling without due care and attention resulted from an initial switch from the term 'compliance' to 'adherence' and then subsequent switch from 'adherence' to 'concordance'. Ready acceptance and usage of the different terms resulted from an erroneous assumption that we wanted to change from measuring what the patient had been told to do, to measuring patient behaviour when they may have played some part in the decision-making process, to measuring patient behaviour when the patient always actively played a part. My failure to recognise that the latter term was not to be used to describe patient medicines-taking behaviour, but was introduced to encourage discussion between the clinician and patient during the prescribing process with the intention of improving adherence, was purely due to a desire to be politically correct. Whilst I now realise that I was not the only person to make this mistake, as I continue to hear the term 'concordance' being misused, the experience probably explains my increased wariness when adopting any new politically correct terminology. Most recently, whilst at a meeting with senior pharmacy managers where I was introducing our Medicines Management Research Team (MMRT), it was quickly pointed out that 'medicines management' was no longer the 'in-term' and that we should be thinking in terms of 'medicines optimisation' as this was now the preferred term for describing pharmacist activities within the UK Department of Health.