Compliance with Instructions in the Evaluation of Therapeutic Efficacy

Abstract

This survey of patient compliance with drug administration reveals that approximately 25 per cent of those seen in the clinic or in hospitals will not be taking drugs as directed. Compliance failures seem to be directly related to the number of drugs taken daily. Few other etiologic factors have been identified. It is difficult for physicians to ascertain which patients have defected from a therapeutic program, yet these defections may lead to false impressions of drug failure. Assessment of compliance can be aided by chemical testing of urine and blood for presence of drug or markers such as riboflavin. Pill counting and patient interviews are not necessarily sensitive indices of compliance. Although not much data are available on the reasons behind compliance failure, intervention which involves supervision and monitoring of patients has increased adherence to a drug regimen. Some of the measures for strengthening compliance are too expensive to be widely applicable, especially in patients with a chronic disease such as epilepsy. Studies using multifactorial analysis of psychologic, social, environmental, and other parameters are needed to develop technics to ensure better compliance in most patients requiring pharmacologic agents.