Dynamics of drug regimen compliance ? its assessment by microprocessor-based monitoring

Abstract

The utility of a new microprocessor-based method for continuous monitoring of compliance in taking solid medicaments has been evaluated. Medication intake in 31 ambulant patients was assessed in a prospective observational study under the conditions of routine practice. The patients (aged 14-87 y, mean 50 y) were receiving long-term drug treatment for various chronic diseases. There was marked interindividual and intraindividual variation in compliance with different drugs. Deviations from the prescribed dosage regimens were caused by omission of doses (22.7% of prescribed doses) and intake of extra doses (5.6% of prescribed doses). Continuous monitoring revealed that in 19% of the monitoring period no medication was taken, in 13% there was partial intake, and in 8% extra doses were taken. Patient-initiated drug holidays occurred in 50% of patients. They were responsible for 76% of the medication-free time. It is concluded, that continuous compliance monitoring is practicable in ambulatory patients. It provides information about the dynamics of drug intake behaviour that cannot be obtained from medical histories or from clinical or laboratory examination. The information could be used effectively in individual patient care and in clinical drug trials.

Use of electronic pill boxes to assess risk of poor treatment compliance Results of a large-scale trial

“…10,11 However, other researchers found no variation in compliance with age. 3,6,12 In the MACH 1 study, younger patients more frequently alter the time at which they take their medication but the number of forgotten doses showed no correlation with the patient's age. 4 In the present study, patient compliance increased regularly with age.…”

“…3 This technique of compliance monitoring allows a refined evaluation of overall compliance and the determination of more accurate compliance parameters such as the percentage of missed, delayed, or multiple doses.…”

Frontmatter and Index

“…In 1977, Professor Weber, previous head of the Department of Clinical Pharmacology at the RuprechtKarl University Heidelberg, initiated the very first compliance symposium in Germany 14 . In her studies she used different measurement methods [15][16][17][18] . Non-compliance is not restricted to ambulatory therapeutic settings, but also occurs among inpatients, as reported from studies including more than 1200 hospitalized patients.…”

Assessing adherence with toothbrushing instructions using a data logger toothbrush

“…Electronic data loggers have been used with great effect to record patterns of behaviour within pharmaceutical clinical trials. [21][22][23] These devices have developed significantly into highly sophisticated tools to monitor behaviour and compliance. With contemporary electronics and power sources it is now possible to integrate data loggers easily within medical devices including, for example powered toothbrushes (PTBs).…”