Using pharmacokinetic-pharmacodynamic relationships to predict the effect of poor compliance.
Since it is difficult to improve patient compliance to drug prescriptions, an alternative is to select a drug with less consequences for poor compliance, that is, a drug that has the capacity of 'forgiveness'. Forgiveness is the property of a drug which, when compared with another medicine with different pharmacokinetics and/or concentration-effect relationships, blunts the consequences of missing one or two doses in a row, or has a greater variability in the timing of intake. Simulations show that drugs with a concentration-effect relationship modelled with an effect compartment, for example a delayed response, have more forgiveness. A marker of forgiveness would be of some help for doctors deciding which drug to prescribe to patients who are poor compliers.
Boissel
Jean-Pierre
JP
Department of Clinical Pharmacology, Claude Bernard University and Teaching Hospital, Lyon, France. jpb@upcl.univ-lyon1.fr
Nony
Patrice
P
D003198:Computer Simulation; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004348:Drug Labeling; D006207:Half-Life; D006801:Humans; D008954:Models, Biological; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D010599:Pharmacokinetics; D010600:Pharmacology; D012306:Risk; D013997:Time Factors; D014018:Tissue Distribution; D016312:Treatment Refusal
D003692:Delayed-Action Preparations; D004364:Pharmaceutical Preparations