[Ambulatory therapeutic noncompliance of the aged treated with digoxin].
OBJECTIVE
To quantify the percentage of out-patient doses (OPD) of Digoxin taken by elderly people in treatment.


METHODS
An observational, longitudinal and retrospective study.


METHODS
Out-patient clinics at a geriatric hospital.


METHODS
67 patients were treated orally with Digoxin: 39 women; age 79 +/- 6; ideal weight, 55.7 Kg +/- 7.1; plasma creatinine, 1.3 +/- 0.9 mg/dl; in-hospital dose 3247.6 +/- 1309.4 ng/Kg; out-patient dose, 3205.7 +/- 1359.9 ng/Kg. They had two consecutive Digoxinemias, one in and one out of hospital, with an interval of 1 to 18 months between them.


RESULTS
Therapeutic compliance was calculated by comparing the Digoxinemia/dose relationship per Kg of the ideal in-hospital weight against the non-hospital one. 37.3% of the patients ingested 80 to 110% of the OPD (95% CI, 26.7%-49.3%). The 36 patients on a constant dosage took 74.3% +/- 34.1% of the OPD, whereas the 31 not on a daily dose took 87.7% +/- 25.3% (P < 0.07).


CONCLUSIONS
Non-compliance is common and hard to detect clinically. Therefore, it is dangerous to adjust the dose of non-compliant patients only on the basis of Digoxinemias or effects of the medicine, or on the doctor's view about compliance.
Cuena Boy
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Unidad de Farmacología Clínica, Hospital Virgen de la Salud, Complejo Hospitalario de Toledo.
Ortiz de Apodaca Ruiz
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MA
D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D004077:Digoxin / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010045:Outpatients; D012189:Retrospective Studies; D013997:Time Factors; D016312:Treatment Refusal
D000889:Anti-Arrhythmia Agents; D002316:Cardiotonic Agents; D004077:Digoxin
Incumplimiento terapéutico ambulatorio en ancianos tratados con digoxina.