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Drug compliance

Published online by Cambridge University Press:  05 December 2011

M. R. Lee
Affiliation:
Clinical Pharmacology Unit, The Royal Infirmary of Edinburgh
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Synopsis

Compliance with drug therapy is a much neglected part of the science of therapeutics. It is a particular problem with certain chronic diseases, for example, hypertension and diabetes; and certain classes of therapeutic agent, for example, anticoagulants and antiepileptics. Methods for the monitoring of compliance are discussed and it is concluded that the best available are either the electronic drug delivery system or chemical monitoring with a suitable long half-life compound. Until modern methods of measuring drug compliance are introduced, patients will surfer disability and even death. It should also be mandatory for controlled clinical trials of new therapeutic entities to include an acceptable mechanism (or method) for the assessment of adherence to the protocol. If not, the results will be vitiated.

Type
Research Article
Copyright
Copyright © Royal Society of Edinburgh 1993

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References

Barrett-Connor, E. 1971. Bacterial infection and sickle cell anemia: An analysis of 250 infections in 166 patients and a review of the literature. Medicine 50, 97112.CrossRefGoogle Scholar
Bergman, A. B. & Werner, R. J. 1963. Failure of children to receive penicillin by mouth. New England Journal of Medicine 268, 1334–8.CrossRefGoogle ScholarPubMed
Bergman, U. & Wiholm, B. -E. 1981. Drug-related problems causing admission to a medical clinic. European Journal of Clinical Pharmacology 20, 193200.CrossRefGoogle ScholarPubMed
Blackwell, B. 1973. Patient compliance. New England Journal of Medicine 289, 249–52.CrossRefGoogle ScholarPubMed
Bulpitt, C. J. & Fletcher, A. E. 1988. Importance of well-being to hypertensive patients. The American Journal of Medicine 84 (Suppl. 1B), 40–6.CrossRefGoogle ScholarPubMed
Charney, E. 1972. Patient–doctor communication. Pediatric Clinics of North America 19, 263-79.CrossRefGoogle ScholarPubMed
Cramer, J. A., Mattson, R. H., Prevey, M. L., Scheyer, R. D. & Ouellette, V. L. 1989. How often is medication taken as prescribed? A novel assessment technique. The Journal of the American Medical Association 261, 3273–7.CrossRefGoogle ScholarPubMed
Croog, S. H., Levine, S., Sudilovsky, A., Baume, R. M. & Clive, J. 1988. Sexual symptoms in hypertensive patients. A clinical trial of antihypertensive medications. Archives of Internal Medicine 148, 788–94.CrossRefGoogle ScholarPubMed
Cummins, D., Heuschkel, R. & Davies, S. C. 1991. Penicillin prophylaxis in children with sickle cell disease in Brent. British Medical Journal 302, 989–90.CrossRefGoogle ScholarPubMed
Curb, J. D., Borhani, N. O., Blaszkowski, T. P., Zimbaldi, N., Fotiu, S. & Williams, W. 1985. Longterm surveillance for adverse effects of antihypertensive drugs. The Journal of the American Medical Association 253, 3263–8.CrossRefGoogle ScholarPubMed
Duxbury, B. McD. 1982. Therapeutic control of anticoagulant treatment. British Medical Journal 284, 702–4.CrossRefGoogle ScholarPubMed
Ellard, G. A., Jenner, P. J. & Downs, P. A. 1980. An evaluation of the potential use of isoniazid, acetylisoniazid and isonicotinic acid for monitoring the self-administration of drugs. British Journal of Clinical Pharmacology 10, 369–81.CrossRefGoogle ScholarPubMed
Epstein, L. H. & Cluss, P. A. 1982. A behavioural medicine perspective on adherence to long-term medical regimens. Journal of Consulting and Clinical Psychology 50, 950–71.CrossRefGoogle ScholarPubMed
Eraker, S. A., Kirscht, J. P. & Becker, M. H. 1984. Understanding and improving patient compliance. Annals of Internal Medicine 100, 258–68.CrossRefGoogle ScholarPubMed
Feely, M., Cooke, J., Price, D., Singleton, S., Mehta, A., Bradford, L. & Calvert, R. 1987. Low-dose phenobarbitone as an indicator of compliance with drug therapy. British Journal of Clinical Pharmacology 24, 7783.CrossRefGoogle ScholarPubMed
Finnerty, F. A. Jr., Shaw, L. W. & Himmelsbach, C. K. 1973. Hypertension in the inner city. II. Detection and follow-up. Circulation 47, 76–8.CrossRefGoogle ScholarPubMed
Goldsmith, C. H. 1979. The effect of compliance distributions on therapeutic trials. In Haynes, R. B., Taylor, D. W. & Sackett, D. L. (Eds) Compliance in health care, pp. 297308. Baltimore, MD: Johns Hopkins University Press.Google Scholar
Gordis, L., Markowitz, M. & Lilienfeld, A. M. 1969. Why patients don't follow medical advice: A study of children on long-term antistreptococcal prophylaxis. The Journal of Pediatrics 75, 957–68.CrossRefGoogle ScholarPubMed
Hardy, E., Kumar, S., Peaker, S., Feely, M. & Pullar, T. 1990. A comparison of a short half-life marker (low-dose isoniazid), a long half-life pharmacological indicator (low-dose phenobarbitone) and measurements of a controlled release ‘therapeutic drug’ (metoprolol, Metoros) in reflecting incomplete compliance by volunteers. British Journal of Clinical Pharmacology 30, 437–41.CrossRefGoogle Scholar
Harries, A. D., Birtwell, A. J. & Jones, D. B. 1981. Anticoagulant control. Lancet 1, 1320.CrossRefGoogle ScholarPubMed
Hogarty, G. E. & Goldberg, S. C. 1973. Drug and sociotherapy in the aftercare of schizophrenic patients: One-year relapse rates. Archives of General Psychiatry 28, 5464.CrossRefGoogle ScholarPubMed
Joubert, P. & Lasagna, L. 1975. Patient package inserts. II. Toward a rational patient package insert. Clinical Pharmacology and Therapeutics 18, 663–9.CrossRefGoogle Scholar
Kaplan, N. M. 1990. Clinical hypertension, Ch. 7, pp. 185–7, Problem of compliance. Baltimore: Williams & Wilkins.Google Scholar
Kruse, W. & Weber, E. 1990. Dynamics of drug regimen compliance – its assessment by microprocessorbased monitoring. European Journal of Clinical Pharmacology 38, 561–5.CrossRefGoogle ScholarPubMed
Kumar, S., Haigh, J. R. M., Rhodes, L. E., Peaker, S., Davies, J. A., Roberts, B. E. & Feely, M. P. 1989. Poor compliance is a major factor in unstable out-patient control of anticoagulant therapy. Thrombosis and Haemoslasis 62 (2), 729–32.Google Scholar
Leistyna, J. A. & Macaulay, J. C. 1966. Therapy of streptococcal infections. Do pediatric patients receive prescribed oral medication? American Journal of Diseases of Children 111, 22–6.CrossRefGoogle ScholarPubMed
McAreavey, D., Ramsay, L. E., Latham, L., McLaren, A. D., Lorimer, A. R., Reid, J. L., Robertson, J. I. S., Robertson, M. P. & Weir, R. J. 1984. ‘Third drug’ trial: comparative study of antihypertensive agents added to treatment when blood pressure remains uncontrolled by a beta blocker plus thiazide diuretic. British Medical Journal 288, 106–11.CrossRefGoogle ScholarPubMed
McInnes, G. T. & Helenglass, G. 1987. The performance of clinics for out-patient control of anticoagulation. Journal of the Royal College of Physicians of London 21, 42–5.Google Scholar
Mäenpää, H., Heinonen, O. P. & Manninen, V. 1991. Medication compliance and serum lipid changes in the Helsinki heart study. British Journal of Clinical Pharmacology 32, 409–15.CrossRefGoogle ScholarPubMed
Mäenpää, H., Javela, K., Pikkarainen, J., Mälkönen, M., Heinonen, O. P. & Manninen, V. 1987. Minimal dose of digoxin: a new marker for compliance to medication. European Heart Journal 8, (Supplement I), 31–7.CrossRefGoogle ScholarPubMed
Martys, C. R. 1979. Adverse reactions to drugs in general practice. British Medical Journal 2, 1194–7.CrossRefGoogle ScholarPubMed
Nolvadex Adjuvant Trial Organisation. 1983. Controlled trial of tamoxifen as adjuvant agent in the management of early breast cancer. Lancet 1, 257–60.Google Scholar
Norell, S. E. 1981. Accuracy of patient interviews and estimates by clinical staff in determining medication compliance. Social Science and Medicine 15E, 5761.CrossRefGoogle Scholar
Norman, G. R., McFarlane, A. H., Streiner, D. L. & Neale, K. 1982. Health diaries: strategies for compliance and relation to other measures. Medical Care 20, 623–9.CrossRefGoogle ScholarPubMed
Peterson, C. E. & Kwaan, H. C. 1986. Current concepts of warfarin therapy. Archives of Internal Medicine 146, 581–4.CrossRefGoogle ScholarPubMed
Pledger, G. W. 1988. Compliance in clinical trials: impact on design, analysis and interpretation. In Schmidt, D. & Leppik, I. E. (Eds) Compliance in epilepsy, pp. 125–33, Elsevier Science Publishers B.V.Google Scholar
Price, D. E., Mehta, A., Park, B. K., Hay, A. & Feely, M. P. 1986. The effect of low-dose phenobarbitone on three indices of hepatic microsomal enzyme induction. British Journal of Clinical Pharmacology 22, 744–7.CrossRefGoogle ScholarPubMed
Pullar, T., Birtwell, A. J., Wiles, P. G., Hay, A. & Feely, M. P. 1988. Use of a pharmacological indicator to compare compliance with tablets prescribed to be taken once, twice or three times daily. Clinical Pharmacology and Therapeutics 44, 540–5.CrossRefGoogle ScholarPubMed
Pullar, T., Kumar, S., Tindall, H. & Feely, M. 1989. Time to stop counting the tablets? Clinical Pharmacology and Therapeutics 46, 163–8.CrossRefGoogle ScholarPubMed
Robinson, M. G. & Watson, R. J. 1966. Pneumococcal meningitis in sickle cell anemia. New England Journal of Medicine 274, 1006–8.CrossRefGoogle ScholarPubMed
Roth, H. P. & Caron, H. S. 1978. Accuracy of doctors' estimates and patients' statements on adherence to a drug regimen. Clinical Pharmacology and Therapeutics 23, 361–70.CrossRefGoogle ScholarPubMed
Svarstad, B. L. 1976. Physician–patient communication and patient conformity with medical advice. In Mechanic, D., (Ed.) The growth of bureaucratic medicine, pp. 220–38, New York: John Wiley.Google Scholar
The Coronary Drug Project Research Group. 1975. Clofibrate and niacin in coronary heart disease. The Journal of the American Medical Association 231, 360–81.CrossRefGoogle Scholar
The Coronary Drug Project Research Group 1980. Influence of adherence to treatment and response of cholesterol on mortality in the coronary drug project. New England Journal of Medicine 303, 1038–41.CrossRefGoogle Scholar
Young, L. M., Haakenson, C. M., Lee, K. K. & van Eeckhout, J. P. 1984. Riboflavin use as a drug marker in Veterans Administration co-operative studies. Controlled Clinical Trials (Suppl.) 497504.CrossRefGoogle Scholar