Perceptions of legitimacy: the influence on medicine taking and prescribing

The terms non-compliance or non-adherence, in relation to medicine taking, contain the assumption that prescribers’ actions are legitimate and should be perceived as such by patients, and that non-adherence is deviant. Yet the high level of non-adherence suggests that patients do not necessarily perceive prescriptions in this way. We consider the relevance today of viewing non-adherence in terms of Weber’s concept of legitimacy. We also consider the more recent concept of concordance. Drawing on an analysis of interviews and consultations from a study of doctor–patient communication about drugs, we argue that decisions about prescribing and medicine taking are complex and take account of social as well as medical criteria. Moreover, any attempt to understand adherence needs to be flexible enough to encompass both a Weberian as well as a concordance approach to prescribing and medicine taking.