Acceptability and compliance with two forms of cholestyramine in the treatment of hypercholesterolemia in children: a randomized, crossover trial.
OBJECTIVE
To compare the acceptability, compliance, and effectiveness of two forms of cholestyramine resin in the treatment of hypercholesterolemia in children.


METHODS
Patients aged 10 to 18 years with familial hypercholesterolemia were enrolled in a randomized, crossover trial of two 8-week periods of either a pill or powder form of cholestyramine at a dose of 8 gm/day.


RESULTS
Of 40 children enrolled, 38 completed both medication periods, with a median age of 13 years (range, 10 to 18). At the end of the study, 82% preferred the pill form, 16% the powder form and 2% neither form. Mean (+/-SD) compliance as assessed by the amount of medication taken was significantly greater for pills (61% +/- 31%) than powder (50% +/- 30%, p = 0.01). The form of the medication increased compliance by at least 25% for 16 patients (42%), 13 in favor of pills and 3 in favor of powder. Compliance was not associated with patient attitudes and perceptions of hypercholesterolemia, demographics, family history, previous experience with lipid-lowering medication, or lipid profile parameters. Significant mean reductions in low-density lipoprotein cholesterol concentrations were noted for both pills (-10% +/- 20%, p = 0.006) and powder (-15% +/- 17%, p = 0.0001), with no significant difference between forms (p = 0.16).


CONCLUSIONS
A change in bile acid-binding resin formulation from powder to pills significantly increases acceptability and compliance in some children with hypercholesterolemia.
McCrindle
B W
BW
Department of Pediatrics, University of Toronto, Hospital for Sick Children, Ontario, Canada.
O'Neill
M B
MB
Cullen-Dean
G
G
Helden
E
E
D000293:Adolescent; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D001294:Attitude to Health; D002648:Child; D002792:Cholestyramine Resin / Q000008:administration & dosage*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D008055:Lipids / Q000097:blood; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000523:psychology; D011208:Powders; D013607:Tablets; D013997:Time Factors
D000924:Anticholesteremic Agents; D008055:Lipids; D011208:Powders; D013607:Tablets; D002792:Cholestyramine Resin