title: Quantifying the impact of non-adherence to drug therapy: a technical note concerning an application of a branch and bound algorithm.
abstract: Pharmacokinetic models typically rely on a key assumption that patients take their medication as prescribed, whereas this is often not the case. We present a branch and bound algorithm that can be used to estimate the time-varying probability that, given a specified pattern of nonadherence to a prescribed regimen, a patient receives no therapeutic benefit from treatment. Use of this algorithm is a much faster method for obtaining this probability than exhaustive computation of the relevant probability distribution. The use of this algorithm to assess, in quantitative terms, the impact of non-adherence on the effectiveness of treatment provides a rational basis for evaluating the potential harm to patients.
authors.affiliation: Clinical Operational Research Unit, University College London, Gower Street, London WC1E 6BT, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Smith
authors.forename: Christina
authors.initials: C
authors.lastname: Pagel
authors.forename: Martin
authors.initials: M
authors.lastname: Utley
authors.forename: Steve
authors.initials: S
authors.lastname: Gallivan
mesh_terms: D000465:Algorithms; D006801:Humans; D015233:Models, Statistical; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D010599:Pharmacokinetics; D016312:Treatment Refusal / Q000706:statistics & numerical data*
chemical_list: D004364:Pharmaceutical Preparations