Inertie thérapeutique : et le patient dans tout ça ?

Various factors, categorized into 5 dimensions (illness, medication, demography and socio-economy, patient and/or patient support and Health care) can influence patient adherence. Physician's perception of these different dimensions of patient adherence may have an impact on medical attitudes, therapeutic inertia. Each dimension is analyzed in terms of perception from the physician and its impact on practice depending on factors such as : understanding the long term, complex prescriptions, socio-economic conditions, representations of health, disease and treatment from the patient and physician, coping strategies and motivation from the patient and physician. The physicianpatient relationship (working alliance) modulates therapeutic inertia and generates negotiated, selected and controlled therapeutic actions by these two actors. Question: what is patient's & physician risk-taking consent, when they don't follow clinical practice guidelines ?