Electronic monitoring of compliance to lipid-lowering therapy in clinical practice.

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State: Public
Version: author
Serval ID
serval:BIB_12707
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Electronic monitoring of compliance to lipid-lowering therapy in clinical practice.
Journal
Journal of Clinical Pharmacology
Author(s)
Schwed A., Fallab C.L., Burnier M., Waeber B., Kappenberger L., Burnand B., Darioli R.
ISSN
0091-2700
ISSN-L
0091-2700
Publication state
Published
Issued date
1999
Peer-reviewed
Oui
Volume
39
Number
4
Pages
402-409
Language
english
Notes
http://jcp.sagepub.com/content/39/4/402.abstract
Abstract
Nonadherence to treatment is a common problem in the clinical management of hypercholesterolemic patients. This study was carried out with the aim of monitoring the daily compliance to a 6-month course of lipid-lowering therapy, using a microelectronic device, the Medication Event Monitoring System (MEMS), versus pill count. Forty men with primary hypercholesterolemia were prescribed fluvastatin 1 x 40 mg daily, provided in a MEMS package to record the date and time of each opening of the pillbox. Thirty-nine of 40 patients (98%) completed the study. Total cholesterol and LDL cholesterol levels decreased significantly (18% and 25%, p < 0.001) during the 6-month therapy period. A high mean rate of compliance was achieved by MEMS using the following three indexes--compliance to total prescribed dose (88.8% +/- 13.5%), compliance to prescribed days (82.4% +/- 19.5%), and compliance to prescribed time of day (81.86% +/- 19.5%)--and by pill count (93.4% +/- 9.5%). In addition, the MEMS provided some patterns of nonadherence to medication, undetectable by pill count alone, such as a drug holiday in 38% of cases, a drug omission for more than 7 consecutive days in 9% of cases, and, conversely, use of more than the one prescribed daily dose in 47% of cases. A significant correlation between the rate of compliance and the decrease in LDL cholesterol was observed only when the compliance was assessed by MEMS. The results indicate that MEMS is a useful tool for monitoring compliance in clinical practice and may possibly increase adherence to long-term lipid-lowering therapy.
Keywords
Adult, Aged, Anticholesteremic Agents, Anxiety, Cholesterol, LDL, Electronics, Medical, Fatigue, Fatty Acids, Monounsaturated, Follow-Up Studies, Humans, Hypercholesterolemia, Indoles, Lipids, Male, Middle Aged, Patient Compliance, Treatment Outcome
Pubmed
Web of science
Create date
19/11/2007 12:04
Last modification date
29/01/2020 7:08
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