Patient compliance: Difference between revisions
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'''Patient compliance''' is "voluntary cooperation of the patient in following a prescribed regimen."<ref>{{MeSH}}</ref> | '''Patient compliance''' is "voluntary cooperation of the patient in following a prescribed regimen."<ref>{{MeSH}}</ref> Noncompliance is common | ||
21942628 | |||
while improving compliance may improve health.<ref name="pmid16916809">{{cite journal |author=Wu JY, Leung WY, Chang S, ''et al'' |title=Effectiveness of telephone counselling by a pharmacist in reducing mortality in patients receiving polypharmacy: randomised controlled trial |journal=BMJ |volume=333 |issue=7567 |pages=522 |year=2006 |pmid=16916809 |doi=10.1136/bmj.38905.447118.2F}}</ref> | |||
Patient compliance is a component of [[health behavior]]. | Patient compliance is a component of [[health behavior]]. | ||
==Prevalence and epidemiology== | ==Prevalence and epidemiology== | ||
"Primary nonadherence is common and may be reduced by lower drug costs and copayments, as well as increased follow-up care with prescribing physicians for patients with chronic conditions.". <ref name="pmid24687067">{{cite journal| author=Tamblyn R, Eguale T, Huang A, Winslade N, Doran P| title=The incidence and determinants of primary nonadherence with prescribed medication in primary care: a cohort study. | journal=Ann Intern Med | year= 2014 | volume= 160 | issue= 7 | pages= 441-50 | pmid=24687067 | doi=10.7326/M13-1705 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24687067 }} </ref> | |||
Among patients who have to take numerous drugs for their health (polypharmacy), not taking all of their medications may lead to poorer health outcomes.<ref name="pmid16790458">{{cite journal |author=Simpson SH, Eurich DT, Majumdar SR, ''et al'' |title=A meta-analysis of the association between adherence to drug therapy and mortality |journal=BMJ |volume=333 |issue=7557 |pages=15 |year=2006 |pmid=16790458 |doi=10.1136/bmj.38875.675486.55}}</ref> | |||
23% of patients report skipping doses or cutting pills in half to make their supply last longer according to one survey.<ref> USA Today/Kaiser Family Foundation/Harvard School of Public Health Survey: the public on prescription drugs and pharmaceutical companies - kaiser family foundation. Retrieved March 10, 2008, from http://www.kff.org/kaiserpolls/pomr030408pkg.cfm.</ref> This is more common among low-income patients. | 23% of patients report skipping doses or cutting pills in half to make their supply last longer according to one survey.<ref> USA Today/Kaiser Family Foundation/Harvard School of Public Health Survey: the public on prescription drugs and pharmaceutical companies - kaiser family foundation. Retrieved March 10, 2008, from http://www.kff.org/kaiserpolls/pomr030408pkg.cfm.</ref> This is more common among low-income patients. | ||
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==How to detect noncompliance== | ==How to detect noncompliance== | ||
A [[systematic review]] by the [http://www.sgim.org/clinexam-rce.cfm Rational Clinical Examination] concluded that missing appointment, not improving with treatment, and counting pills are the best methods to detect non-compliance.<ref name="pmid8492406">{{cite journal |author=Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G |title=The rational clinical examination. Is this patient taking the treatment as prescribed? |journal=JAMA |volume=269 |issue=21 |pages=2779–81 |year=1993 |pmid=8492406 |doi=}} [http://jama.ama-assn.org/cgi/reprint/269/21/2779 pdf]</ref> | A [[systematic review]] by the [http://www.sgim.org/clinexam-rce.cfm Rational Clinical Examination] concluded that missing appointment, not improving with treatment, and counting pills are the best methods to detect non-compliance.<ref name="pmid8492406">{{cite journal |author=Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G |title=The rational clinical examination. Is this patient taking the treatment as prescribed? |journal=JAMA |volume=269 |issue=21 |pages=2779–81 |year=1993 |pmid=8492406 |doi=10.1001/jama.1993.03500210079036}} [http://jama.ama-assn.org/cgi/reprint/269/21/2779 pdf]</ref> | ||
==Methods to improve compliance== | ==Methods to improve compliance== | ||
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{| class="wikitable" border="1" align="right" | {| class="wikitable" border="1" align="right" | ||
|+ Dosing frequency and compliance | |+ Dosing frequency and compliance | ||
! Doses per day!! % of days in<br/> compliance<ref name=" | ! Doses per day!! % of days in<br/> compliance<ref name="pmid11558866">{{cite journal| author=Claxton AJ, Cramer J, Pierce C| title=A systematic review of the associations between dose regimens and medication compliance. | journal=Clin Ther | year= 2001 | volume= 23 | issue= 8 | pages= 1296-310 | pmid=11558866 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11558866 }} </ref> | ||
|- | |- | ||
| One|| style="text-align:center" | | | One|| style="text-align:center" | 79 | ||
|- | |- | ||
| Two|| style="text-align:center" | | | Two|| style="text-align:center" |69 | ||
|- | |- | ||
| Three|| style="text-align:center" | | | Three|| style="text-align:center" |65 | ||
|- | |||
| Four|| style="text-align:center" |51 | |||
|} | |} | ||
Medications that are taken less often per day may be easier to comply with.<ref name="pmid11558866">{{cite journal| author=Claxton AJ, Cramer J, Pierce C| title=A systematic review of the associations between dose regimens and medication compliance. | journal=Clin Ther | year= 2001 | volume= 23 | issue= 8 | pages= 1296-310 | pmid=11558866 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11558866 }} </ref><ref name="pmid21079218">{{cite journal| author=Shrank WH, Choudhry NK, Fischer MA, Avorn J, Powell M, Schneeweiss S et al.| title=The epidemiology of prescriptions abandoned at the pharmacy. | journal=Ann Intern Med | year= 2010 | volume= 153 | issue= 10 | pages= 633-40 | pmid=21079218 | doi=10.1059/0003-4819-153-10-201011160-00005 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21079218 }} </ref><ref name="pmid16270428">{{cite journal |author=Treharne GJ, Lyons AC, Kitas GD |title=Adherence to medication |journal=N. Engl. J. Med. |volume=353 |issue=18 |pages=1972-4; author reply 1972-4 |year=2005 |pmid=16270428 |doi=}}</ref> Fixed-dose combination drugs can help.<ref name="pmid18288541">{{cite journal |author=Pan F, Chernew ME, Fendrick AM |title=Impact of fixed-dose combination drugs on adherence to prescription medications |journal=J Gen Intern Med |volume=23 |issue=5 |pages=611–4 |year=2008 |month=May |pmid=18288541 |doi=10.1007/s11606-008-0544-x |url=http://dx.doi.org/10.1007/s11606-008-0544-x |issn=}}</ref><ref name="pmid17563050">{{cite journal |author=Gerbino PP, Shoheiber O |title=Adherence patterns among patients treated with fixed-dose combination versus separate antihypertensive agents |journal=Am J Health Syst Pharm |volume=64 |issue=12 |pages=1279–83 |year=2007 |month=June |pmid=17563050 |doi=10.2146/ajhp060434 |url=http://www.ajhp.org/cgi/pmidlookup?view=long&pmid=17563050 |issn=}}</ref> Similarly, [[polypharmacy]] should be avoided. | Medications that are taken less often per day may be easier to comply with.<ref name="pmid11558866">{{cite journal| author=Claxton AJ, Cramer J, Pierce C| title=A systematic review of the associations between dose regimens and medication compliance. | journal=Clin Ther | year= 2001 | volume= 23 | issue= 8 | pages= 1296-310 | pmid=11558866 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11558866 }} </ref><ref name="pmid21079218">{{cite journal| author=Shrank WH, Choudhry NK, Fischer MA, Avorn J, Powell M, Schneeweiss S et al.| title=The epidemiology of prescriptions abandoned at the pharmacy. | journal=Ann Intern Med | year= 2010 | volume= 153 | issue= 10 | pages= 633-40 | pmid=21079218 | doi=10.1059/0003-4819-153-10-201011160-00005 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21079218 }} </ref><ref name="pmid16270428">{{cite journal |author=Treharne GJ, Lyons AC, Kitas GD |title=Adherence to medication |journal=N. Engl. J. Med. |volume=353 |issue=18 |pages=1972-4; author reply 1972-4 |year=2005 |pmid=16270428 |doi=}}</ref> Fixed-dose combination drugs can help.<ref name="pmid18288541">{{cite journal |author=Pan F, Chernew ME, Fendrick AM |title=Impact of fixed-dose combination drugs on adherence to prescription medications |journal=J Gen Intern Med |volume=23 |issue=5 |pages=611–4 |year=2008 |month=May |pmid=18288541 |doi=10.1007/s11606-008-0544-x |url=http://dx.doi.org/10.1007/s11606-008-0544-x |issn=}}</ref><ref name="pmid17563050">{{cite journal |author=Gerbino PP, Shoheiber O |title=Adherence patterns among patients treated with fixed-dose combination versus separate antihypertensive agents |journal=Am J Health Syst Pharm |volume=64 |issue=12 |pages=1279–83 |year=2007 |month=June |pmid=17563050 |doi=10.2146/ajhp060434 |url=http://www.ajhp.org/cgi/pmidlookup?view=long&pmid=17563050 |issn=}}</ref> Similarly, [[polypharmacy]] should be avoided. | ||
Reminders sent to patients, especially telephone calls, may improve compliance with [[vaccination]]s.<ref name="pmid11025835">{{cite journal| author=Szilagyi PG, Bordley C, Vann JC, Chelminski A, Kraus RM, Margolis PA et al.| title=Effect of patient reminder/recall interventions on immunization rates: A review. | journal=JAMA | year= 2000 | volume= 284 | issue= 14 | pages= 1820-7 | pmid=11025835 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11025835 }} </ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Latest revision as of 05:51, 7 May 2015
Patient compliance is "voluntary cooperation of the patient in following a prescribed regimen."[1] Noncompliance is common 21942628 while improving compliance may improve health.[2]
Patient compliance is a component of health behavior.
Prevalence and epidemiology
"Primary nonadherence is common and may be reduced by lower drug costs and copayments, as well as increased follow-up care with prescribing physicians for patients with chronic conditions.". [3]
Among patients who have to take numerous drugs for their health (polypharmacy), not taking all of their medications may lead to poorer health outcomes.[4]
23% of patients report skipping doses or cutting pills in half to make their supply last longer according to one survey.[5] This is more common among low-income patients.
In a study of compliance over one year with medications for hypertension[6]
- Half of the patients stopped taking a medicine completely (non-persistence)
- 43% of patients took drug holidays in which they did not take a medication for three days or more (non-execution)
Patients are more likely to abandon prescriptions that are expensive.[7]
How to detect noncompliance
A systematic review by the Rational Clinical Examination concluded that missing appointment, not improving with treatment, and counting pills are the best methods to detect non-compliance.[8]
Methods to improve compliance
| Doses per day | % of days in compliance[9] |
|---|---|
| One | 79 |
| Two | 69 |
| Three | 65 |
| Four | 51 |
Medications that are taken less often per day may be easier to comply with.[9][7][10] Fixed-dose combination drugs can help.[11][12] Similarly, polypharmacy should be avoided.
Reminders sent to patients, especially telephone calls, may improve compliance with vaccinations.[13]
References
- ↑ Anonymous (2024), Patient compliance (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Wu JY, Leung WY, Chang S, et al (2006). "Effectiveness of telephone counselling by a pharmacist in reducing mortality in patients receiving polypharmacy: randomised controlled trial". BMJ 333 (7567): 522. DOI:10.1136/bmj.38905.447118.2F. PMID 16916809. Research Blogging.
- ↑ Tamblyn R, Eguale T, Huang A, Winslade N, Doran P (2014). "The incidence and determinants of primary nonadherence with prescribed medication in primary care: a cohort study.". Ann Intern Med 160 (7): 441-50. DOI:10.7326/M13-1705. PMID 24687067. Research Blogging.
- ↑ Simpson SH, Eurich DT, Majumdar SR, et al (2006). "A meta-analysis of the association between adherence to drug therapy and mortality". BMJ 333 (7557): 15. DOI:10.1136/bmj.38875.675486.55. PMID 16790458. Research Blogging.
- ↑ USA Today/Kaiser Family Foundation/Harvard School of Public Health Survey: the public on prescription drugs and pharmaceutical companies - kaiser family foundation. Retrieved March 10, 2008, from http://www.kff.org/kaiserpolls/pomr030408pkg.cfm.
- ↑ Vrijens B, Vincze G, Kristanto P, Urquhart J, Burnier M. Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing histories. BMJ. 2008 May 17;336(7653):1114-7. Epub 2008 May 14. PMID 18480115
- ↑ 7.0 7.1 Shrank WH, Choudhry NK, Fischer MA, Avorn J, Powell M, Schneeweiss S et al. (2010). "The epidemiology of prescriptions abandoned at the pharmacy.". Ann Intern Med 153 (10): 633-40. DOI:10.1059/0003-4819-153-10-201011160-00005. PMID 21079218. Research Blogging.
- ↑ Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G (1993). "The rational clinical examination. Is this patient taking the treatment as prescribed?". JAMA 269 (21): 2779–81. DOI:10.1001/jama.1993.03500210079036. PMID 8492406. Research Blogging. pdf
- ↑ 9.0 9.1 Claxton AJ, Cramer J, Pierce C (2001). "A systematic review of the associations between dose regimens and medication compliance.". Clin Ther 23 (8): 1296-310. PMID 11558866. [e]
- ↑ Treharne GJ, Lyons AC, Kitas GD (2005). "Adherence to medication". N. Engl. J. Med. 353 (18): 1972-4; author reply 1972-4. PMID 16270428. [e]
- ↑ Pan F, Chernew ME, Fendrick AM (May 2008). "Impact of fixed-dose combination drugs on adherence to prescription medications". J Gen Intern Med 23 (5): 611–4. DOI:10.1007/s11606-008-0544-x. PMID 18288541. Research Blogging.
- ↑ Gerbino PP, Shoheiber O (June 2007). "Adherence patterns among patients treated with fixed-dose combination versus separate antihypertensive agents". Am J Health Syst Pharm 64 (12): 1279–83. DOI:10.2146/ajhp060434. PMID 17563050. Research Blogging.
- ↑ Szilagyi PG, Bordley C, Vann JC, Chelminski A, Kraus RM, Margolis PA et al. (2000). "Effect of patient reminder/recall interventions on immunization rates: A review.". JAMA 284 (14): 1820-7. PMID 11025835. [e]