Adherence to drug therapy. An outpatient survey at the Johnnesburg General Hospital
Kritzinger, N.A.
South African Medical Journal 58(19): 767-770
1980
ISSN/ISBN: 0256-9574 PMID: 7423325 Document Number: 165329
The findings of a survey of 450 patients recieving medicine from the Johannesburg General Hospital, who were interviewed regarding their adherence to prescribed medicinal regimens, are reviewed. Of the patients, 116 were interviewed at home, where, in addition, the remaining tablets were counted; results are re-analyzed and discussed. This study showed that age, sex, financial status, employment status and type of drug issued played no significant part in predicting non-adherence to medicinal therapy. The highest level of education obtained influenced compliance (P < 0.04). Whether the patient saw the same doctor or not did not influence compliance, but significantly more patients who did not adhere to their prescribed therapy complained of lack of explanation from the doctor regarding the medicines (P < 0.005). The prescription of > 2 tablets (P < 0.001) or > 2 regimens (P < 0.001) or the inclusion of a 4-times-a-day regimen (P < 0.05) significantly increased the incidence of non-adherence to prescribed therapy, as did the removal of tablets from the original container (P < 0.01). The survey showed that the incidence of non-adherence reported at hospital differed significantly from that when patients were interviewed at home, where a simultaneous pill-count was conducted (P < 0.001). Where appropriate: 4-times-a-day regimens should be avoided; the number of tablets and number of different regimens should be kept to a minimum and the use of a unit dose pack be investigated. In such a pack, each unit would contain those preparations required to be taken at a particular time and the patient would take everything contained in the single pack prescribed for that occasion, but the content may vary, so that in practice, the patient may be on a single regimen and a single tablet. The importance of doctor-pharmacist-patient communication is emphasized.