Poor visit keeping is associated with poor medication compliance

The Science behind the Tip

Factors associated with poor medication compliance have been determined for a number of chronic internal disorders that like glaucoma most often have no immediate symptoms. Frequent breaking of appointments with a physician appeared to be associated with poor medication compliance and poorer health outcomes in patients with for example epilepsy(1), hyperlipidemia(2) or diabetes(3). As a consequence, missed appointments have been proposed as an opportunity for the physician to identify non-compliant patients(3).

A similar association between poor visit keeping and poor medication compliance has been observed in glaucoma patients4. Thus, although many patients fail to take their glaucoma medications as prescribed5, one should particularly be alert to this problem in the case of visit defaulters.

In order to check compliance, it may not be very useful to ask the patient whether he/she took the medication(s) as directed. Instead, putting forth the question Can you tell me how you took your medicine? is more likely to result in a truthful answer.

Contributor: Ann Hoste, Antwerp
Co-editors: John Thygesen and Ann Hoste
Peer reviewers: Roger Hitchings and Anders Heijl

References

1. Mattson RH, Cramer JA, Collins JF. Aspects of compliance: taking drugs and keeping clinic appointments. Epilepsy Res Suppl. 1988;1:111-7.

2. Kiortsis DN, Giral P, Bruckert E, et al. Factors associated with low compliance with lipid-lowering drugs in hyperlipidemic patients. J Clin Pharm Ther. 2000;25:445-51.

3. Karter AJ, Parker MM, Moffet HH, et al. Missed appointments and poor glycemic control: an opportunity to identify high-risk diabetic patients. Med Care. 2004;42:110-5.

4. Kosoko O, Quigley HA, Vitale S, et al. Risk factors for noncompliance with glaucoma follow-up visits in a residents' eye clinic. Ophthalmology. 1998;105:2105-11.

5. Schwartz GF. Compliance and persistency in glaucoma follow-up treatment. Curr Opin Ophthalmol. 2005;16:114-21.

Tip Reviewer: Roger Hitchings
Tip Editors: Ann Hoste, John Salmon and John Thygesen