Summary
The objective of the study was to investigate patient compliance with two different dosage regimens. Ethinyloestradiol 80 μg daily was prescribed to 35 female outpatients to be taken as 20 μg four times daily or 40 μg twice daily for 7 days. It was given to standardise cervical mucus before a sperm cervical mucus penetration-test (SCMPT) was performed. Sixty-five patients with primary infertility (mean age 29.9 y) completed the study. Compliance was assessed by microprocessor-based compliance monitoring. Besides compliance (percentage of prescribed doses taken), the adherence of the patients to the dosage schedule was evaluated — ‘regimen compliance’. The latter parameter of drug intake behaviour was calculated by the number of days in which 2 (BID) or 4 openings (QID) were recorded by the electronic monitor. As a third parameter, the deviation from the prescribed dosing intervals, i.e. 12 or 6 h, was also determined. Partial compliance was the predominant finding and only 9 patients (13.8%) were over-compliant. Mean compliance was 75.7% in all 65 patients as a group, range 7.1 to 143%. The mean compliance with the QID regimen was 67% compared to 85% with the BID regimen. ‘Regimen compliance’, the percentage of doses taken on schedule, was 36% and 63% for the QID and BID regimens, respectively. Drug-intake behaviour was more erratic with the QID than the BID regimen, as indicated by the 55% of opening intervals recorded which exceeded the range of 3–9 h (mean: 6 h), compared to only 19% exceeding 6–18 h intervals (mean: 12 h). The present study provides evidence that the prescribed dosage frequency has an impact on drug compliance by patients. From a practical point of view, it seems reasonable to use treatment regimens that are as simple as possible, provided that they are pharmacologically and clinically appropriate.
Similar content being viewed by others
References
Haynes RB (1979) Determinants of compliance: the disease and mechanics of treatment. In: Haynes RB, Tayor DW, Sackett DL (eds) Compliance in health care. Johns Hopkins University Press, Baltimore, pp 49–62
Parkin DM, Henney CR, Quirk J, Crooks J (1976) Deviation from prescribed drug treatment after discharge from hospital. Br Med J 2: 686–688
Asplund J, Danielsen M, Öhman P (1984) Patient compliance in hypertension — the importance of number of tablets. Br J Clin Pharmacol 17: 547–552
Wong BSM, Norman DC (1987) Evaluation of a novel medication aid, the calendar blister-pak, and its effect on drug compliance in a geriatric outpatient clinic. J Am Geriatr Soc 35: 21–26
Leirer O, Morrow DG, Pariante GM, Sheikh JI (1988) Elders' non-adherence, its assessment, and computer assisted instruction for medical recall training. J Am Geriatr Soc 36: 877–884
Pullar T, Birtwell AJ, Wiles PG, Hay A, Feely MP (1988) Use of a pharmacologic indicator to compare compliance with tablets prescribed to be taken once, twice or three times daily. Clin Pharmacol Ther 44: 540–545
Cramer JA, Mattson RH, Prevey ML, Scheyer RD, Quellette VL (1989) How often is medication taken as prescribed? A novel assessment technique. JAMA 261: 3273–3277
Eisen SA, Miller DK, Woodward RS, Spitznagel E, Przybeck TR (1990) The effect of prescribed daily dose frequency on patient medication compliance. Arch Intern Med 150: 1881–1884
Cheung R, Nicholson PW, Dickins J, Deshmukh AA, O'Neill CJA, Dobbs RJ, Dobbs SM (1988) Value of a pill-box with a concealed monitoring device in a clinical trial and in routine practice. Br J Clin Pharmacol 26: 661P-662P
Kruse W, Weber E (1990) Dynamics of drug regimen compliance — its assessment by microprocessor-based monitoring. Eur J Clin Pharmacol 38: 561–565
Eggert-Kruse W, Leinhos G, Gerhard I, Tilgen W, Runnebaum B (1989) Prognostic value of in vitro sperm penetration into hormonally standardized human cervical mucus. Fertil Steril 51: 317–323
Weber E (1980) Grundriß der biologischen Statistik. G Fischer, Stuttgart
Kass MA, Meltzer DW, Gordon M, Cooper D, Goldberg J (1986) Compliance with topical pilocarpine treatment. Am J Ophthalmol 101: 515–523
Kass MA, Gordon M, Morley RE, Meltzer DW, Goldberg J (1987) Compliance with topical timolol treatment. Am J Ophthalmol 103: 188–193
Kruse W, Schlierf G, Weber E (1989) Continuous compliance monitoring — its utility for the interpretation of drug trials. Eur J Clin Pharmacol 36 [Suppl A]: 289
Sackett DL, Snow JC (1979) The magnitude of compliance and non-compliance. In: Haynes RB, Taylor DW, Sackett DL (eds) Compliance in health care. Johns Hopkins University Press, Baltimore, pp 11–22
Coats AJS, Adamopoulos S, Meyer TE, Conway J, Sleight P (1990) Effects of physical training in chronic heart failure. Lancet I: 63–66
Feinstein A (1990) On white-coat effects and the electronic monitoring of compliance. Arch Intern Med 150: 1377–1378
Gordis L (1979) Conceptual and methodological problems in measuring patient compliance. In: Haynes RB, Taylor DW, Sackett DL (eds) Compliance in health care. Johns Hopkins University Press, Baltimore, pp 23–45
Mäenpää H, Manninen V, Heinonen OP (1987) Comparison of digoxin marker with capsule counting and compliance questionnaire methods for measuring compliance to medication in a clinical trial. Eur Heart J 8 [Suppl 1]: 39–43
Rudd P, Byyny RL, Zachary V, LoVerde ME, Titus C, Mitchell WD, Marshall G (1989) The natural history of medication compliance in a drug trial: limitations of pill counts. Clin Pharmacol Ther 46: 169–174
Rudd P, Ahmed S, Zachary V, Barton C, Bonduelle D (1990) Improved compliance measures: Applications in an ambulatory hypertensive drug trial. Clin Pharmacol Ther 48: 676–685
Norell SE (1982) Malignant compliance. Lancet I: 50
Weintraub M, Au WYW, Lasagne L (1973) Compliance as a determinant of serum digoxin concentration, JAMA 224: 481–485
Cheung R, Dickins J, Nicholson PW, Thomas ASC, Smith HH, Larson HE, Deshmukh AA, Dobbs RJ, Dobbs SM (1988) Compliance with antituberculous therapy: a field trial of a pill-box with a concealed electronic recording device. Eur J Clin Pharmacol 22: 401–407
Haynes RB, Sackett DL, Taylor DW, Roberts RG, Johnson AL (1977) Manipulation of the therapeutic regimen to improve compliance: conceptions and misconceptions. Clin Pharmacol Ther 22: 125–130
Greenberg RN (1984) Overview of patient compliance with medication dosing: a literature review. Clin Ther 6: 592–599
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kruse, W., Eggert-Kruse, W., Rampmaier, J. et al. Dosage frequency and drug-compliance behaviour — a comparative study on compliance with a medication to be taken twice or four times daily. Eur J Clin Pharmacol 41, 589–592 (1991). https://doi.org/10.1007/BF00314990
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00314990