Patient compliance and

Sustained-release theophylline preparations improve patient compliance and achieve more consistent serum concentrations than rapid-release theophylline and aminophylline preparations. Caution should be used in switching from one sustained-release preparation to another because there are considerable variations in sustained-release characteristics. 

Bondesson A, Hellstrom L, Eriksson T, Hoglund P (2009) A structured questionnaire to asses patient compliance and beliefs about medicines taken account of the ordered categorical structure of data. J Eval Clin Pract (in press)... 

It is now becoming apparent that a single daily dose (rather than 2-3 doses per day) significantly enhances patient compliance and, therefore, effectiveness of treatment. For this reason, the long-acting diuretics which can be administered once a day offer an important advantage chlorthalidone, metolazone, trichlor-methiazide can be administered once a day with a 24 hour natriuretic effect. 

Clearly the major advantage of all the recently introduced antidepressants lies in their relative safety in overdosage and reduced side effects. These factors are particularly important when considering the need for optimal patient compliance and in the treatment of the elderly depressed patient who is more likely to experience severe side effects from antidepressants. 

Physicians reported mixed feelings about the impact of DTCA on their patients and practices— More than 70 percent felt that DTCA helped educate patients about available treatments 67% felt that DTCA helped them have better discussions with their patients, ffowever, four out of five doctors believed that DTCA did not provide information in a balanced manner, and a similar number felt that it encouraged patients to seek treatments they did not need. Physicians as a group were more equivocal about other impacts of DTCA, with 46 percent agreeing that it increased patients compliance and 32 percent that it made patients less confident in their doctors judgment. Overall, 40 percent felt that DTCA had a positive effect on their patients and their practices, 30% felt it had a negative effect, and 30% felt that it had no effect. ... 

Nondegradable polymers are also useful as matrices for ocular implants. This application requires the polymer to be hydrophilic, to minimize local tissue irritation. Need for ocular implants stems from the challenges posed to conventional ocular medicines (i.e., eye drops) such as rapid dilution, tear washout, poor patient compliance, and limited bioavailability. Ocular implants from hydrophilic polymer matrices that provide localized sustained release may overcome the above limitations. The first polymeric sustained release product to reach the market was Ocusert , a pilocarpin sustained release ocular implant developed by Alza. Ocusert has the drug reservoir as a thin disc of pilocarpine-alginate complex sandwiched between two transparent discs of microporous membrane fabricated from ethylene-vinyl acetate copolymer. The microporous membranes permit the tear fluid to penetrate into the drug reservoir compartment to dissolve pilocarpine from the complex. Pilocarpine molecules are then released at a constant rate of 20 or 40 pg/hr for a four- to seven-day management of glaucoma. 

Let us consider each issue in turn the definition and measurement of patient compliance, and the value of information about patient compliance and its correlates in a changing health care environment. 

Ideally, biomarkers should be measurable in a versatile and easily accessible body fluid, such as serum or urine, to maximize clinical use in terms of patient compliance and readiness to interface with the diagnostic... 

Ehrlich s inspiration continues to be a major driving force behind the design and development of modern drug delivery systems. The precise targeting of a tissue, organ, or cell population will eventually create distinctly superior delivery systems that will result in better treatment outcome, better patient compliance, and greatly improved economics of drug treatment. 

Improved patient compliance and acceptability of the drag therapy. 

Violations of protocol must be identified and characterized, and some member of the team should be dispatched to give the needed explanations and corrective actions. Note especially adherence to enrollment criteria, the drug administration regimen, including the duration of washout periods (if any), patient compliance, and the specified clinical and laboratory observations. The periodic computer checks can identify the site(s), if any, that are outliers from the average of other sites. 

Both the type of drug delivery system and the specific type of delivery device can affect drug absorption via the nasal route. The choice of delivery system depends mainly on the physiochemical properties of the drug, its desired site of action, and, more importantly, patient compliance and marketing aspects. The formulations most commonly used in nasal delivery are solutions, suspensions, gels, dry powders, and, most recently, nanoparticulate formulations. 

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