Measurement of patient compliance.

The compliance of 91 diabetic patients using oral antidiabetics was studied. Patient compliance was measured using four different methods. Patients received their medication in a Medication Event Monitoring System (MEMS)-container. Each time the patient went back to the pharmacy for refill prescriptions, the number of tablets left in the container were counted. Pharmacy records were used to study the number of days of delay in getting the next refill. At the end of the study, a questionnaire was sent to every patient. Using MEMS as a standard, the results show that pill count and refill data overestimate the compliance of this group of patients. The MEMS data also show that the compliance data using only the number of tablets may be biased, because of possible overconsumption. Pill count does not show a correlation with compliance as measured by MEMS. The relation between compliance as measured with MEMS and refill compliance is weak.

Impact of dosage frequency on patient compliance.

OBJECTIVE: To evaluate the impact of dosage frequency on the compliance of patients who receive their medicines from community pharmacies. RESEARCH DESIGN AND METHODS: Each month, patients received a supply of their medication in a Medication Event Monitoring Systems container, which registered each opening of the package. At the end of the study, the patients received a short questionnaire. The subjects were 91 diabetic patients using oral antidiabetic agents. Patients taking insulin and those who were unable to collect their medicines from the pharmacy were excluded from the study. Compliance was defined as the percentage of doses taken during the observation period. Another parameter used was compliance with the prescribed regimen, defined as the percentage of days in which the number of tablets were taken as prescribed. As a last parameter, compliance with the prescribed dose intervals was used. RESULTS: Compliance is influenced by the frequency of doses. The compliance for this group of patients is 74.8%, with an average of 79% in the case of a dose once daily and 38% in the case of a dose three times daily. The predominant type of noncompliance in all groups was dose omissions. However, more than one-third of the patients used more doses than prescribed. Overconsumption is a frequently made mistake by patients on a one-dose daily schedule. CONCLUSIONS: The reduction of dose frequency may decrease total noncompliance, but at the same time, it increases the risk of overconsumption. Reducing the frequency does not automatically result in a better therapeutic schedule. The choice of once or twice daily should depend on the therapeutic range of the drug.

Halopemide and benzodiazepine binding sites.

Halopemide inhibits 3H-BZ binding to crude and washed rat forebrain membranes with IC50 values of 16-25 microM. Its putative metabolites are considerably less active. The actions of halopemide are probably not directly related to its ability to interfere with high-affinity 3H-GABA binding sites. However, halopemide may have some unique properties in this regard.