The use of a pharmacological indicator to investigate compliance in patients with a poor response to antirheumatic therapy.
Twenty-six patients with rheumatoid arthritis which was poorly controlled despite high dose D-penicillamine were studied. Compliance was assessed by standard methods (return tablet count and interview). In addition low-dose phenobarbitone was included in the penicillamine formulation as a pharmacological indicator of compliance. Using these techniques incomplete compliance was apparent in 11 patients (42%). All such patients were identified by the pharmacological marker. Only one admitted poor compliance at interview and only six returned more than a few tablets too many. The reason for the high incidence of poor compliance in this selected group is not apparent but it may represent a significant cause of failure with D-penicillamine therapy. The use of low-dose phenobarbitone may have wider applications in the investigation of patients with other conditions who fail to respond adequately to treatment.
Pullar
T
T
Department of Medicine, University of Leeds.
Peaker
S
S
Martin
M F
MF
Bird
H A
HA
Feely
M P
MP
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010349:Patient Compliance; D010396:Penicillamine / Q000627:therapeutic use; D010634:Phenobarbital / Q000097:blood
D010396:Penicillamine; D010634:Phenobarbital