Concordance and children's use of medicines

Concordance is usually established between two people, doctor and patient, but the use of drugs in children always involves a third partner, the parents. Developing concordance with children in their health care raises several questions with no straightforward answers. For example, should children have a more active role in taking decisions about health and drugs than they currently do? Should greater emphasis be placed on informing parents about the disease and its treatment or on direct communication with their sick child? From what age should children be addressed directly about their illness? What is really relevant for them? Do children's and parents' perceptions about the usefulness and risks (efficacy), rules, and use of drugs coincide? This article, based on qualitative studies of children's perceptions and attitudes to health, disease, and drug use, presents information that, though by no means providing the right answers to the above questions, might be useful when considering the options.