Noncompliance with medication regimen

Noncompliance with Medication Regimens An Economic Tragedy. Emerging Issues in Pharmaceutical Cost Containing National Pharmaceutical Council Washington, DC, 1992 1-16. 

Patient noncompliance with prescription regimens is one of the most understated problems in the health care system. The effects of noncompliance have enormous ramifications for patients, caregivers, and health professionals. Compliance with medications is a worldwide problem, and measures that are effective in one country may not have work elsewhere. 

Noncompliance with the medication regimen is the next most common factor. Therapeutic drug monitoring can be useful to confirm suspected noncompliance. The physician can then address the reasons for noncompliance with the patient. 

Nonadherence to medication regimens remains a major problem in health care. The National Council on Patient Information and Education (NCPIE) has termed noncompliance America s other drug problem.Pharmacists are in an ideal position to assess and treat adherence-related problems that can adversely affect patients health outcomes. Strategies to monitor and improve adherence are key components of pharmaceutical care plans, especially for patients with chronic diseases, such as hypertension, diabetes, and atherosclerotic heart disease. Nonadherence is a behavioral disorder that can be assessed and managed through a carefully devised pharmaceutical care plan. 

Noncompliance with prescribed medication regimens is a major problem in pharmacotherapy and results in 300,000 deaths in the United States annually. There are three distinguishing phases to noncompliance (a) acclimatization period, (b) compliance with the decision, and (c) discontinuation. Several methods are used to measure patient compliance to drug therapy. They range from direct questioning and the use of interview instruments, to patient diaries, pill counts, MEMS, drug... 

Patients with peptic ulcer disease who develop recurrent ulcer signs or symptoms of Cl bleeding or perforation should be referred to a specialist. Assess reasons for therapeutic failure, including noncompliance to the drug regimen, antibiotic resistance (HPeradication), heavy smoking, NSAID use, and the need for HP eradication in a patient on conventional antiulcer medications. 

Medication noncompliance may be the single most common reason for treatment failure. It is estimated that up to 60% of patients with epilepsy are noncompliant. " The rate of noncompliance is increased by the complexity of the drug regimen and by doses taken three and four times a day. Noncompliance is not influenced by age, sex, psychomotor development, seizure type, or seizure frequency. " ... 

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