Malignant compliance

Methods in assessing drug compliance

Methods and problems in assessing drug compliance are related to the selection of study sample and observation period as well as to methods used to measure patient behaviour in taking medications. Patients under treatment with a certain drug regimen are different from the patients for whom that regimen was originally prescribed. Medication compliance during short periods of time, such as 1-2 weeks before or after a visit to the clinic, is likely to be different from that found over longer periods of time. Several studies indicate that estimates by clinical staff are no more accurate than chance selections in determining medication compliance. Patient interviews have usually identified 25-50% of noncompliant patients, but interview data on spacing between doses seem to be more accurate. Pill counts are useful in assessing drug compliance, although compliance may sometimes be overestimated. Medication monitors provide more detailed information on patient behaviour in taking medications.

Dosage frequency and drug-compliance behaviour--a comparative study on compliance with a medication to be taken twice or four times daily

The objective of the study was to investigate patient compliance with two different dosage regimens. Ethinyloestradiol 80 micrograms daily was prescribed to 35 female outpatients to be taken as 20 micrograms four times daily or 40 micrograms twice daily for 7 days. It was given to standardise cervical mucus before a sperm cervical mucus penetration-test (SCMPT) was performed. Sixty-five patients with primary infertility (mean age 29.9 y) completed the study. Compliance was assessed by microprocessor-based compliance monitoring. Besides compliance (percentage of prescribed doses taken), the adherence of the patients to the dosage schedule was evaluated--'regimen compliance'. The latter parameter of drug intake behaviour was calculated by the number of days in which 2 (BID) or 4 openings (QID) were recorded by the electronic monitor. As a third parameter, the deviation from the prescribed dosing intervals, i.e. 12 or 6 h, was also determined. Partial compliance was the predominant finding and only 9 patients (13.8%) were over-compliant. Mean compliance was 75.7% in all 65 patients as a group, range 7.1 to 143%. The mean compliance with the QID regimen was 67% compared to 85% with the BID regimen. 'Regimen compliance', the percentage of doses taken on schedule, was 36% and 63% for the QID and BID regimens, respectively. Drug-intake behaviour was more erratic with the QID than the BID regimen, as indicated by the 55% of opening intervals recorded which exceeded the range of 3-9 h (mean: 6 h), compared to only 19% exceeding 6-18 h intervals (mean: 12 h).(ABSTRACT TRUNCATED AT 250 WORDS)