Kruse W, Koch-Gwinner P, Nikolaus T, Oster P, Schlierf G, Weber E
Geriatrisches Zentrum Bethanien am Klinikum der Universität, Heidelberg, FRG.
J Am Geriatr Soc. 1992 Nov;40(11):1151-5. doi: 10.1111/j.1532-5415.1992.tb01806.x.
A pilot study to assess patient compliance with medication by using a new measurement technique, continuous electronic monitoring.
Survey. Compliance monitors were provided to eligible patients at discharge from the hospital to measure drug intake behavior prospectively for a period of 3 weeks.
Ambulant patient care after discharge from a geriatric hospital, Krankenhaus Bethanien, which is affiliated with the University Clinic, Heidelberg.
A consecutive convenience sample of 18 independently living elderly patients (median age 76 years) completed the study. The patients were on maintenance therapy with cardiac glycosides and/or potassium-sparing diuretics prescribed to be taken once daily.
The monitoring method provides information about patients' real timing of drug use by continuously recording date and time of openings and closings of the medication containers (monitors). In addition to a standard measure, the percentage of prescribed doses taken, information about regularity of drug use is obtained.
Compliance, percentage of prescribed doses taken, was remarkably variable; it ranged from 24% to 100%, 95% CI: 62%-84%. Mean compliance declined from the first to the third week after discharge, 85% vs 69%, 95% CI: 74%-95% and 56%-81%, respectively (P < 0.05). Omissions of doses, the predominant pattern of non-compliance, were observed in 17 of 18 patients. Regularity of dose timing, as defined by the number of interdose intervals within 24 h +/- 15%, varied from 10% to 100%, 95% CI: 46%-76%.
Continuous electronic monitoring revealed highly variable compliance in patients prescribed maintenance therapy. Even with a once-daily regimen, persistent and high compliance cannot be assumed. The monitoring technique may be of great value to research and, possibly, to practical therapeutic management.
开展一项试点研究，通过使用一种新的测量技术——连续电子监测，来评估患者的用药依从性。
调查研究。在符合条件的患者出院时为其提供依从性监测仪，以前瞻性地测量为期3周的药物摄入行为。
海德堡大学诊所附属的老年医院贝塔尼安医院出院后的门诊患者护理。
连续选取18名独立生活的老年患者（中位年龄76岁）组成便利样本完成了该研究。这些患者正在接受强心苷和/或保钾利尿剂的维持治疗，规定每日服用一次。
该监测方法通过持续记录药盒（监测仪）打开和关闭的日期及时间，提供患者实际用药时间的信息。除了标准测量指标（服用的规定剂量百分比）外，还可获取用药规律性的信息。
依从性，即服用的规定剂量百分比，差异显著；范围为24%至100%，95%置信区间：62% - 84%。出院后第一周与第三周的平均依从性有所下降，分别为85%和69%，95%置信区间分别为74% - 95%和56% - 81%（P < 0.05）。在18名患者中有17名出现了漏服药物的情况，这是不依从的主要模式。按照24小时内给药间隔次数±15%定义的给药时间规律性，范围为10%至100%，95%置信区间：46% - 76%。
连续电子监测显示，接受维持治疗的患者依从性差异很大。即使是每日一次的治疗方案，也不能假定患者能持续保持高依从性。该监测技术可能对研究以及可能对实际治疗管理具有重要价值。
