Abstract
Partial medication compliance, where patients do not take enough of their prescribed medicine to achieve adequate outcomes, is common. Research using electronic monitoring to assess compliance has shown that people take approximately 75% of doses as prescribed, irrespective of the condition being treated or its severity. Erratic compliance often leads to discontinuation of therapy, as treatment is perceived to be ineffective. Compliance decreases as frequency of dosing increases. Inadequate compliance and treatment persistence results in poor outcomes, despite the best efforts of the medical team. It is important to develop and implement a strategy to improve compliance. Simple steps that can be taken include helping patients to select "cues" to remind them to take their tablets, use of dose reminder boxes, and visual feedback of compliance data from electronic monitors.
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Figure 1 .
Four week electronic dosing record for a patient prescribed a medication to be taken twice a day, showing erratic compliance on weekdays and neglect at the weekend.
Figure 2 .
Poor treatment persistence with antihypertensive medications. Data from Jones et al.6
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Burnier M., Schneider M. P., Chioléro A., Stubi C. L., Brunner H. R. Electronic compliance monitoring in resistant hypertension: the basis for rational therapeutic decisions. J Hypertens. 2001 Feb;19(2):335–341. doi: 10.1097/00004872-200102000-00022. [DOI] [PubMed] [Google Scholar]
- Claxton A. J., Cramer J., Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther. 2001 Aug;23(8):1296–1310. doi: 10.1016/s0149-2918(01)80109-0. [DOI] [PubMed] [Google Scholar]
- Cramer J. A. Consequences of intermittent treatment for hypertension: the case for medication compliance and persistence. Am J Manag Care. 1998 Nov;4(11):1563–1568. [PubMed] [Google Scholar]
- Cramer J. A., Mattson R. H., Prevey M. L., Scheyer R. D., Ouellette V. L. How often is medication taken as prescribed? A novel assessment technique. JAMA. 1989 Jun 9;261(22):3273–3277. [PubMed] [Google Scholar]
- Cramer J. A., Rosenheck R. Enhancing medication compliance for people with serious mental illness. J Nerv Ment Dis. 1999 Jan;187(1):53–55. doi: 10.1097/00005053-199901000-00009. [DOI] [PubMed] [Google Scholar]
- Cramer J. A., Scheyer R. D., Mattson R. H. Compliance declines between clinic visits. Arch Intern Med. 1990 Jul;150(7):1509–1510. [PubMed] [Google Scholar]
- Degli Esposti Luca, Degli Esposti Ezio, Valpiani Giorgia, Di Martino Mirko, Saragoni Stefania, Buda Stefano, Baio Gianluca, Capone Alessandro, Sturani Alessandra. A retrospective, population-based analysis of persistence with antihypertensive drug therapy in primary care practice in Italy. Clin Ther. 2002 Aug;24(8):1347–1346. doi: 10.1016/s0149-2918(02)80039-x. [DOI] [PubMed] [Google Scholar]
- Heeschen Christopher, Hamm Christian W., Laufs Ulrich, Snapinn Steven, Böhm Michael, White Harvey D., Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Investigators Withdrawal of statins increases event rates in patients with acute coronary syndromes. Circulation. 2002 Mar 26;105(12):1446–1452. doi: 10.1161/01.cir.0000012530.68333.c8. [DOI] [PubMed] [Google Scholar]
- Jones J. K., Gorkin L., Lian J. F., Staffa J. A., Fletcher A. P. Discontinuation of and changes in treatment after start of new courses of antihypertensive drugs: a study of a United Kingdom population. BMJ. 1995 Jul 29;311(7000):293–295. doi: 10.1136/bmj.311.7000.293. [DOI] [PMC free article] [PubMed] [Google Scholar]