Thursday, September 13, 2018

Think before you prescribe Prescribe simpler drug regimens to improve treatment adherence

Compliance to prescribed treatment is a major factor influencing the desired treatment outcome and is largely dependent on the patient. Non-compliance with the drug treatment continues to be a common problem in practice. 

A systematic review of 76 studies examining the associations between dose regimens and medication compliance showed that the prescribed number of daily doses is inversely related to compliance. Adherence declined as the number of daily doses increased. Simpler, less frequent dosing regimens resulted in better compliance.  Compliance was significantly higher for once-daily vs 3-times-daily, once-daily vs 4-times-daily and twice-daily vs 4-times-daily regimens (Clin Ther. 2001;23:1296-1310).

Patients were again shown to be more compliant with once-daily compared with twice-daily or thrice-daily treatment regimens in another systematic review of 20 studies. Patients receiving once-daily dosing had 22% to 41% more adherent days compared with patients receiving thrice-daily dosing; patients receiving once-daily dosing had 2% to 44% more adherent days compared with patients receiving twice-daily dosing indicating that the once-daily dose regimen had the highest adherence rates in this study (Am J Manag Care. 2009;15:e22-e33).

Adherence with any medication regimen decreases with the number of doses prescribed. Therefore, if you prescribe a complex drug regimen with more number of medications, your patients are more likely to not respond well to treatment.  

So, to improve patient adherence to the treatment prescribed, keep it simple.

Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA

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