Untitled

Abstract

The compliance of 91 diabetic patients using oral antidiabetics was studied. Patient compliance was measured using four different methods. Patients received their medication in a Medication Event Monitoring System (MEMS)-container. Each time the patient went back to the pharmacy for refill prescriptions, the number of tablets left in the container were counted. Pharmacy records were used to study the number of days of delay in getting the next refill. At the end of the study, a questionnaire was sent to every patient. Using MEMS as a standard, the results show that pill count and refill data overestimate the compliance of this group of patients. The MEMS data also show that the compliance data using only the number of tablets may be biased, because of possible overconsumption. Pill count does not show a correlation with compliance as measured by MEMS. The relation between compliance as measured with MEMS and refill compliance is weak.

Refill compliance in type 2 diabetes mellitus: a predictor of switching to insulin therapy?

“…a comparison between the prescribed medication vs. the medication in the patient's home) or pill count. 9,26 One important advantage is avoidance of any Hawthorne effect (i.e. improvement of performance when the subject is under observation) by assessing compliance retrospectively by review of prescription-refill records.…”

“…28 Paes and his colleagues already proposed that the use of refill data might be especially useful in the community pharmacy setting. 9 One advantage of this method is that pharmacy computers can deliver a signal if the patient is too late for his or her refill. 7 It provides the possibility to monitor a large number of patients without extra investments.…”

“…9,10,12,30 For example, Paes et al examined the compliance as registered by MEMS 1 (Medication Event Monitoring System) devices of a group type 2 diabetes mellitus patients. 12 They excluded patients using a weekly dose organizer (a substantial part in an elderly population).…”

“…29 Other cons of this method are that nothing can be said about patients getting their refills on time, the cause of noncompliance is unknown and in general the results will overestimate compliance. 9 For instance, it is quite common to cash a repeat prescription several days before it is needed for reasons of convenience. However, the occurrence of this phenomenon is not expected to be different between cases and controls.…”

“…In several studies assessing adherence to glucose lowering regimens, overall compliance rates between 64 and 83% were found for oral hypoglycemic agents. [9][10][11][12] The prescription refill records of centralized pharmacies are a potential source of information about patient compliance. Based on the assumption that a patient cannot be compliant when he has not obtained sufficient medications, refill compliance can be measured.…”