Antihypertensive medication-taking. Investigation of a simple regimen.
In search of strategies to improve compliance, we assessed medication-taking behavior among 19 ambulatory hypertensives, using both pill counts and electronic monitoring. The regimen consisted of one pill each day for < or = 63 weeks with return visits at 1 to 4 week intervals. The study population was 79% male, 68% white, and 16% black with mean (+/- SEM) age 58.4 +/- 2.5 years. Only 51% of the intervisit intervals displayed > or = 80% of vial openings within the desirable range (24 +/- 6 h). Pill counts detected only 2% of suboptimal interdosing intervals identified by electronic monitoring. Early changes in compliance correlated well with later changes (r = 0.83, P = .002). A few of the subjects exhibited a large deviation from the prescription, uncorrectable with drugs having a long duration of action. We conclude that (a) pill counts tend to overestimate patients' compliance rates; (b) changes in medication-taking behavior early in therapy may predict subsequent compliance rates; and (c) prolonging drug action may compensate for some imperfect medication-taking behavior.
Guerrero
D
D
Stanford University School of Medicine, California.
Rudd
P
P
Bryant-Kosling
C
C
Middleton
B
B
Middleton BF [corrected to Middleton
B ]
B]
D000328:Adult; D002985:Clinical Protocols; D004311:Double-Blind Method; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017275:Isradipine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D010349:Patient Compliance; D012107:Research Design
D017275:Isradipine