HOW OFTEN IS MEDICATION TAKEN AS PRESCRIBED - A NOVEL ASSESSMENT TECHNIQUE
HOW OFTEN IS MEDICATION TAKEN AS PRESCRIBED - A NOVEL ASSESSMENT TECHNIQUE
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DOI：
10.1001/jama.261.22.3273
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发表时间：
1989-06-09
影响因子：
120.7
通讯作者：
OUELLETTE, VL
中科院分区：
文献类型：
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作者：
CRAMER, JA;MATTSON, RH;OUELLETTE, VL
当患者不遵守规定的治疗方案时，药物疗效的评价会受到混淆。用药过量、用药不足和不稳定的给药间隔会降低药物作用或引起不良反应。我们使用一种新的方法，以癫痫为模型，评估了新治疗和长期治疗患者对长期药物治疗的依从性。药物事件监测系统（Aprex Corporation，Fremont，加州，美国）是标准药瓶，在瓶盖中具有微处理器，以记录每次开瓶作为推定剂量。在观察的3428天内，依从率平均为76%：87%的每日一次、81%的每日两次、77%的每日三次和39%的每日四次剂量按规定服用。血药浓度变异系数与服药依从率无显著相关性。药丸计数高估的依从性越来越符合规定的方案下降。药物血清浓度或药丸计数均无法识别连续给药观察结果显示的漏服剂量频率。
The evaluation of the efficacy of medication is confounded when patients do not adhere to prescribed regimens. Overdosing, underdosing, and erratic dosing intervals can diminish drug action or cause adverse effects. Using a new method with epilepsy as a model, we assessed compliance with long-term medications among newly treated and long-term patients. Medication Event Monitor Systems (Aprex Corporation, Fremont, California, USA) are standard pill bottles with microprocessors in the cap to record every bottle opening as a presumptive dose. Compliance rates averaged 76% during 3428 days observed: 87% of the once daily 81% of the twice daily, 77% of the three times a day, and 39% of the four times a day dosages were taken as prescribed. Coefficients of variation of drug serum concentrations had o significant relationship to compliance rates. Pill counts overestimated compliance increasingly as compliance with the prescribed regimen declined. Neither drug serum concentrations nor pill counts would have identified the frequency of missed doses that were revealed with continuous dose observations.