Improving on a Coin Toss To Predict Patient Adherence to Medications

Editorials15 May 2001Improving on a Coin Toss To Predict Patient Adherence to MedicationsBarbara J. Turner, MD, MSEd and Frederick M. Hecht, MDBarbara J. Turner, MD, MSEdUniversity of Pennsylvania; Philadelphia, PA 19104 (Turner)San Francisco General Hospital; San Francisco, CA 94110 (Hecht) and Frederick M. Hecht, MDUniversity of Pennsylvania; Philadelphia, PA 19104 (Turner)San Francisco General Hospital; San Francisco, CA 94110 (Hecht)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-10-200105150-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail According to the father of medicine, Hippocrates, "The physician must not only be prepared to do what is right himself, but also to make the patient … cooperate" (1). Although Hippocrates' paternalistic tone might affront modern physicians and patients, the challenge of promoting patient adherence to effective treatments still confounds providers 23 centuries later. Adherence has become an increasingly central aspect of patient care because of the burgeoning array of effective treatments for many chronic diseases. In the face of remarkable medical advances, it is especially distressing that evaluation of patient adherence (also called compliance or pill taking) remains an ...References1. Adams F. Genuine Works of Hippocrates. Melbourne, FL: Krieger Publishing; 1972. Google Scholar2. Liu H, Golin CE, Miller LG, Hays RD, Beck CK, Sanandaji S, et al . A comparison study of multiple measures of adherence to HIV protease inhibitors. Ann Intern Med. 2001;134:968-77. LinkGoogle Scholar3. Nichol MB, Venturini F, Sung JC. A critical evaluation of the methodology of the literature on medication compliance. Ann Pharmacother. 1999;33:531-40. 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PMID: 0010197299 CrossrefMedlineGoogle Scholar8. George CF, Peveler RC, Heiliger S, Thompson C. Compliance with tricyclic antidepressants: the value of four different methods of assessment. Br J Clin Pharmacol. 2000;50:166-71. PMID: 0010930969 CrossrefMedlineGoogle Scholar9. Andrejak M, Genes N, Vaur L, Poncelet P, Clerson P, Carré A. Electronic pill-boxes in the evaluation of antihypertensive treatment compliance: comparison of once daily versus twice daily regimen. Am J Hypertens. 2000;13:184-90. PMID: 0010701819 CrossrefMedlineGoogle Scholar10. Cramer J, Vachon L, Desforges C, Sussman NM. Dose frequency and dose interval compliance with multiple antiepileptic medications during a controlled clinical trial. Epilepsia. 1995;36:1111-7. PMID: 0007588455 CrossrefMedlineGoogle Scholar11. Mushlin AI, Appel FA. Diagnosing potential noncompliance. Physicians' ability in a behavioral dimension of medical care. Arch Intern Med. 1977;137:318-321. PMID: 0000843149 CrossrefMedlineGoogle Scholar12. Bergman AB, Werner RJ. Failure of children to receive penicillin by mouth. N Engl J Med. 1963;268:1334-8. CrossrefMedlineGoogle Scholar13. Fletcher SW, Pappius EM, Harper SJ. Measurement of medication compliance in a clinical setting. Comparison of three methods in patients prescribed digoxin. Arch Intern Med. 1979;139:635-8. PMID: 0000443967 CrossrefMedlineGoogle Scholar14. Haynes RB, Taylor DW, Sackett DL, Gibson ES, Bernholz CD, Mukherjee J. Can simple clinical measurements detect patient noncompliance? Hypertension. 1980;2:757-64. PMID: 0007007235 CrossrefMedlineGoogle Scholar15. Fallab-Stubi CL, Zellweger JP, Sauty A, Uldry C, Iorillo D, Burnier M. Electronic monitoring of adherence to treatment in the preventive chemotherapy of tuberculosis. Int J Tuberc Lung Dis. 1998;2:525-30. PMID: 0009661817 MedlineGoogle Scholar16. Low-Beer S, Yip B, O'Shaughnessy MV, Hogg RS, Montaner JS. Adherence to triple therapy and viral load response Letter. J Acquir Immune Defic Syndr. 2000;23:360-1. PMID: 0010836763 CrossrefMedlineGoogle Scholar17. Maher K, Klimas N, Fletcher MA, Cohen V, Maggio CM, Triplett J, et al . Disease progression, adherence, and response to protease inhibitor therapy for HIV infection in an Urban Veterans Affairs Medical Center. J Acquir Immune Defic Syndr. 1999;22:358-63. PMID: 0010634197 CrossrefMedlineGoogle Scholar18. Gifford AL, Bormann JE, Shively MJ, Wright BC, Richman DD, Bozzette SA. Predictors of self-reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens. J Acquir Immune Defic Syndr. 2000;23:386-95. PMID: 0010866231 CrossrefMedlineGoogle Scholar19. Haynes RB, Sackett DL, Gibson ES, Taylor DW, Hackett BC, Roberts RS, et al . Improvement of medication compliance in uncontrolled hypertension. Lancet. 1976;1:1265-8. PMID: 0000073694 CrossrefMedlineGoogle Scholar20. Dunn G. The problem of measurement error in modelling the effect of compliance in a randomized trial. Stat Med. 1999;18:2863-77. PMID: 0010523747 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania; Philadelphia, PA 19104 (Turner)San Francisco General Hospital; San Francisco, CA 94110 (Hecht)Corresponding Author: Barbara J. Turner, MD, MSEd, University of Pennsylvania, 1122 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104; e-mail, email protectedmed.upenn.edu.Current Author Addresses: Dr. Turner: University of Pennsylvania, 1122 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104.Dr. Hecht: University of California at San Francisco Positive Health Program, San Francisco General Hospital, Ward 84, 995 Potrero Avenue, San Francisco, CA 94110. 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