Compliance in hypertensive patients and patients with cardiac insufficiency
Lüscher, T.; Tuma, J.; Scheu, H.; Haase, W.; Tenschert, W.; Ammann, D.; Völlm, K.; Vetter, W.
Schweizerische Medizinische Wochenschrift 111(52): 2047-2050
1981
ISSN/ISBN: 0036-7672 PMID: 7330654 Document Number: 176863
In the present study the compliance or drug-adherence of 83 patients with hypertension (n = 66), heart failure (n = 14) or edema of non-cardiac origin (n = 3) was investigated by the urine fluorescence method over an observation period of 17.8 +/- 15.1 weeks. Mean compliance rate of all patients was 79.7%. Individual drug-adherence ranged from 0 to 100%. Half of the patients (54.2%; n = 45) had positive urine samples in all investigations performed. A quarter (25.3%; n = 21) were compliant in over 50%, whereas in 14.5% (n = 12) the drug could be detected in the urine in only 10 to 50% of the tests and in 6% (n = 5) in less than 10%. The 17 symptomatic patients (patients with heart failure and/or edemas) showed a slightly better compliance (87.0%) than patients with hypertension, who had positive urine samples in 77.3 +/- 30.1% of tests. However, the difference observed was not statistically significant. During treatment a decrease in compliance from 82% at the first visit to 73% and 75% respectively at the second and third could be observed. Finally, at the fourth and fifth consultation only 62.2% and 56% respectively of the patients had positive urine samples. Our results show a good compliance rate in our patients as compared to American studies. During treatment a continuous decrease in compliance could be observed. Our results indicate that the duration of treatment seems to be an important determinant for the patient's drug-adherence. Therefore, it appears necessary to perform compliance-improving strategies as early as after the first follow-up visits.