The University of Southampton
University of Southampton Institutional Repository

From compliance to concordance: barriers to accomplishing a re-framed model of health care interactions

Bissell, Paul, May, Carl and Noyce, Peter R. (2004) From compliance to concordance: barriers to accomplishing a re-framed model of health care interactions Social Science & Medicine, 58, (4), pp. 851-862. (doi:10.1016/S0277-9536(03)00259-4).

Record type: Article


As a framework for organising health care interactions, compliance and adherence have come in for increasing criticism in recent years. It has been suggested that interactions with patients should not be viewed simply as opportunities to reinforce instructions around treatment: rather, they should be seen as a space where the expertise of patients and health professionals can be pooled to arrive at mutually agreed goals. This concept—known as concordance—is attracting increasing interest in health services research within the UK. In this paper, we seek to empirically explore the relevance of a re-framed consultation through qualitative interviews with a small group of English speaking patients of Pakistani origin with a diagnosis of type 2 diabetes.

We suggest that the focus of many respondents in this study on material and structural factors limiting diabetic regimen integration and the emphasis on a ‘doctor-centred’ model of health care interactions represent distinct problems for the accomplishment of the concordance project. However, given that some patients sought greater understanding and appreciation by health professionals of the subjective aspects of living with diabetes, if it is evaluated at the level of health care relationships, rather than health outcomes (such as improved compliance) concordance may well be a significant development for those who suggest that respect for the patients agenda is a fundamental aspect of health care.

Full text not available from this repository.

More information

Published date: February 2004
Keywords: concordancem, compliance, diabetes, doctor–patient interaction, ethnic minorities, uk


Local EPrints ID: 163513
ISSN: 0277-9536
PURE UUID: b0627128-4c58-415c-95c5-0a1d0304073c
ORCID for Carl May: ORCID iD

Catalogue record

Date deposited: 09 Sep 2010 14:36
Last modified: 18 Jul 2017 12:31

Export record



Author: Paul Bissell
Author: Carl May ORCID iD
Author: Peter R. Noyce

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton:

ePrints Soton supports OAI 2.0 with a base URL of

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.