Aspects of compliance: taking drugs and keeping clinic appointments.
Treatment of epilepsy depends on adherence to a drug regimen as prescribed and periodic assessment of progress. Typical problems of compliance to medication and adherence to follow-up in long-term epilepsy treatment in a clinical trial were analyzed. Zero drug levels, subtherapeutic levels, variable levels and delayed dose were measures of non-compliance to the drug regimen. Missed visits and non-drug-related dropouts from the study marked non-adherence. Data from 622 patients participating in a multicenter evaluation of the efficacy and toxicity of carbamazepine, phenobarbital, phenytoin and primidone, showed generally good compliance. Only 5% of patients had zero drug levels or greater than or equal to 24 h since prior dose at 2 or more visits. Good adherence to the protocol was demonstrated by 93% attendance as scheduled. The support structure of the study and the availability of a study assistant helped many patients to prevent potential problems and convert patients into excellent adherers.
Mattson
R H
RH
Epilepsy Center, Veterans Administration Medical Center, West Haven, CT 06516.
Cramer
J A
JA
Collins
J F
JF
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000097:blood / Q000627:therapeutic use*; D001071:Appointments and Schedules; D002220:Carbamazepine / Q000097:blood / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004828:Epilepsies, Partial / Q000188:drug therapy / Q000523:psychology; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010044:Outpatient Clinics, Hospital; D010349:Patient Compliance; D010634:Phenobarbital / Q000097:blood / Q000627:therapeutic use; D010672:Phenytoin / Q000097:blood / Q000627:therapeutic use; D011324:Primidone / Q000097:blood / Q000627:therapeutic use; D011446:Prospective Studies
D000927:Anticonvulsants; D011324:Primidone; D002220:Carbamazepine; D010672:Phenytoin; D010634:Phenobarbital