- Email: [email protected]
Compliance, treatment practices and blood pressure control: Community survey findings
50
SELECTED ABSTRACTS
From Australia, Canada, East Germany, England, India, Switzerland, the United States, and West Germany come abstracts for this issue. Those chosen have been selected to respond to the interests of readers in the areas of Compliance with Therapeutic Regimens, Patient Education/Health Education, Professional Preparation and Professional Relations, Genetic Counselling, Communication Technology, and Philosophy and Ethical Issues in health care. One finds in reading these abstracts a rather heavy concern for patients with chi-onic diseases, genetic conditions, and with patients for whom long-term care is indicated. Indeed, when prevention is discussed, one must deal with several levels of prevention including primary, secondary, and tertiary levels. The selections here indicate somewhat of an!emphasis in world literature on the later stages of prevention. More studies dealing with primary prevention and health promotion will be sought out for future issues. COMPLIANCE WITH THERAPEUTIC REGIMENS India, Switzerland, and the United States provide reports reflecting continuing concern with the problems of patient compliance with therapeutic regimens indicating what we believe to be a problem recognized on a world-wide basis. What is clear from the five abstracts here is that compliance with long-term therapy for patients with chronic diseases is a pressing problem for health-care practitioners. What is demonstrated by these reports is also the importance of determining early in the treatment what factors in the individual, in his family setting, and in the community may be important in the continuance of treatment. 1) Compliance, treatment practices and blood pressure control: Community survey findings W A G N E R , E . H . , T R U E S D A L E , R . A . , JR., and WARNER, J.T. Dept. Epidemiol., Sch. Publ. Hlth. Med., Univ. North Carolina, Chapel Hill, NC, U.S.A. J. Chronic Dis. 34(11), 519-525, 1981 The influence of drug compliance and treatment regimen on blood pressure control was examined among
385 treated hypertensive patients identified during prevalence survey of a rural biracial community. Com. pliance with all antihypertensive drugs, measured a., rarely or never missing doses, was reported by 74% ol treated hypertensive patients. Reported compliance differed significantly by the number of drugs taken bul not by demographic characteristics. Diastolic blood pressure control (DBP < 90 mmHg) was better amon8 compliers than noncompliers (72% vs 61%, P < 0.05). Among those whose DBPs were elevated, however, twe thirds were compliant and most were taking either .~ single drug or a single combination tablet. Conversely, the relatively high rate of DBP control among noncompliant individuals coupled with the very high preva. lence of antihypertensive drug treatment among women, particularly white women, raises the possibility of overtreatment.
2) Medication compliance in hyperactive children KAUFMANN, R.E., SMITH-WRIGHT, D., REESE C.A., et al. Child. Hosp. Michigan, Wayne State Univ., Detroit, Mich., U.S.A. Pediatr. Pharmacol. 1(3), 231-237, 1981 Medication compliance was studied over an 18-week period in 12 male children, ages 6 to 12 years, whc were receiving medication for hyperactivity. Subject~ were randomly assigned to receive placebo (PB), d-amphetamine (AMP), and methylphenidate (MPH) fol six weeks each in a triple-blind, crossover design. Urine samples were obtained weekly and assayed for MPH and AMP to assess compliance. Individual patient compliance varied from 0.00% to 100% (mean = 67%) while taking MPH and from 20% to 83% (mean = 60%) while taking AMP. The percent of patients complianl for a given week varied from 55% to 80% (mean = 67%) when taking MPH and from 25% to 83% (mean = 61%) when taking AMP. Significant positive noncompliance also occurred: that is, MPH was found in urine during the PB period in five of 12 individuals. Poor compliance in taking medication may explain, i~ part, the variable and conflicting results reported in many studies of the effect of medication on improving the behavior of hyperactive children.
PATIENT COUNSELLING AND HEALTH EDUCATIO1
SELECTED ABSTRACTS
From Australia, Canada, East Germany, England, India, Switzerland, the United States, and West Germany come abstracts for this issue. Those chosen have been selected to respond to the interests of readers in the areas of Compliance with Therapeutic Regimens, Patient Education/Health Education, Professional Preparation and Professional Relations, Genetic Counselling, Communication Technology, and Philosophy and Ethical Issues in health care. One finds in reading these abstracts a rather heavy concern for patients with chi-onic diseases, genetic conditions, and with patients for whom long-term care is indicated. Indeed, when prevention is discussed, one must deal with several levels of prevention including primary, secondary, and tertiary levels. The selections here indicate somewhat of an!emphasis in world literature on the later stages of prevention. More studies dealing with primary prevention and health promotion will be sought out for future issues. COMPLIANCE WITH THERAPEUTIC REGIMENS India, Switzerland, and the United States provide reports reflecting continuing concern with the problems of patient compliance with therapeutic regimens indicating what we believe to be a problem recognized on a world-wide basis. What is clear from the five abstracts here is that compliance with long-term therapy for patients with chronic diseases is a pressing problem for health-care practitioners. What is demonstrated by these reports is also the importance of determining early in the treatment what factors in the individual, in his family setting, and in the community may be important in the continuance of treatment. 1) Compliance, treatment practices and blood pressure control: Community survey findings W A G N E R , E . H . , T R U E S D A L E , R . A . , JR., and WARNER, J.T. Dept. Epidemiol., Sch. Publ. Hlth. Med., Univ. North Carolina, Chapel Hill, NC, U.S.A. J. Chronic Dis. 34(11), 519-525, 1981 The influence of drug compliance and treatment regimen on blood pressure control was examined among
385 treated hypertensive patients identified during prevalence survey of a rural biracial community. Com. pliance with all antihypertensive drugs, measured a., rarely or never missing doses, was reported by 74% ol treated hypertensive patients. Reported compliance differed significantly by the number of drugs taken bul not by demographic characteristics. Diastolic blood pressure control (DBP < 90 mmHg) was better amon8 compliers than noncompliers (72% vs 61%, P < 0.05). Among those whose DBPs were elevated, however, twe thirds were compliant and most were taking either .~ single drug or a single combination tablet. Conversely, the relatively high rate of DBP control among noncompliant individuals coupled with the very high preva. lence of antihypertensive drug treatment among women, particularly white women, raises the possibility of overtreatment.
2) Medication compliance in hyperactive children KAUFMANN, R.E., SMITH-WRIGHT, D., REESE C.A., et al. Child. Hosp. Michigan, Wayne State Univ., Detroit, Mich., U.S.A. Pediatr. Pharmacol. 1(3), 231-237, 1981 Medication compliance was studied over an 18-week period in 12 male children, ages 6 to 12 years, whc were receiving medication for hyperactivity. Subject~ were randomly assigned to receive placebo (PB), d-amphetamine (AMP), and methylphenidate (MPH) fol six weeks each in a triple-blind, crossover design. Urine samples were obtained weekly and assayed for MPH and AMP to assess compliance. Individual patient compliance varied from 0.00% to 100% (mean = 67%) while taking MPH and from 20% to 83% (mean = 60%) while taking AMP. The percent of patients complianl for a given week varied from 55% to 80% (mean = 67%) when taking MPH and from 25% to 83% (mean = 61%) when taking AMP. Significant positive noncompliance also occurred: that is, MPH was found in urine during the PB period in five of 12 individuals. Poor compliance in taking medication may explain, i~ part, the variable and conflicting results reported in many studies of the effect of medication on improving the behavior of hyperactive children.
PATIENT COUNSELLING AND HEALTH EDUCATIO1