Table E7.2. Techniques to improve medication compliance

Enlist patient participation

- Ask specifically about missed doses (number & reasons)

- Ask about medication-related problems - listen to answers

- Ask specifically about medication side-effects

- Ask about drug costs/payments Simplify regimen

- Prescribe more "forgiving" (longer acting) drugs

- Minimize number of daily doses (once-twice daily is best)

- Eliminate drugs not clearly needed at this time Observe / Investigate

- Randomly measure blood levels of drug (note -?erratic levels)

- Consider noncompliance when clinical picture is unusual (lack of clinical response to drugs at usual doses)

- Followup on unusual prescription refill patterns

- Followup on unexplained, missed clinic or laboratory visits


1. Matas AJ. Relationship between acute and chronic rejection (elsewhere in this volume).

2. Glynn RJ, Buring JE, Manson JE, LaMotte F, Hennekens CH. Adherence to aspirin in the prevention of myocardial infarction. Arch Intern Med 1994; 154:2649-2657.

3. Lang JM, Buring JE, Rosner B, Cook N, Hennekens CH. Estimating the effect of the run-in on the power of the physicians' health study. Statis in Med 1991; 10:15851593.

4. Nevins TE, Kruse L, Skeans MA, Thomas W. The natural history of azathioprine compliance after renal transplantation. Kidney Int 2001; 60:1565-1570.

5. Frazier P, Davis-Ali S, Dahl K. Correlates of noncompliance among renal transplant recipients. Clin Transplantation 1994; 8:550-557.

6. Terasaki PI, Cecka JM, Gjertson DW, Cho YW. Spousal and other living renal donor transplants. Clinical Transplants 1997; 269-284,.

7. Rudman LA, Gonzales MH, Borgida E. Mishandling the gift of life: Noncompli-ance in renal transplant patients. J Applied Social Psychology 1999; 29:835-852.

8. Boudes P. Drug compliance in therapeutic trials: A review. Controlled Clin Trials 1998; 19:251-268.

9. Laederach-Hofmann K and Bunzel B. Noncompliance in organ transplant recipients: A literature review. General Hospital Psychiatry 2000; 22:412-424.

10. Schweizer RT, Rovelli M, Palmeri D, Vossler E, Hull D, Bartus S. Noncompliance in organ transplant recipients. Transplantation 1990; 49:374-377.

11. Dunn J, Golden D, Van Buren CT, et al. Causes of graft loss beyond two years in the cyclosporine era. Transplantation 1990; 49(2):349-353.

12. Gaston R, Hudson S, Ward M, et al. Late renal allograft loss: noncompliance masquerading as chronic rejection. Transplant Proc 1999; 31(4A):21S-23S.

13. DeGeest S, Borgermans L, Gemoets H, et al. Incidence, determinants, and consequences of subclinical noncompliance with immunosuppressive therapy in renal transplant recipients. Transplantation 1995; 59(3):340-347.

14. DeGeest SD, Abraham I, Moons P, et al. Late acute rejection and subclinical non-compliance with cyclosporine therapy in heart transplant recipients. Journal of Heart and Lung Transplantation 1998; 17(9):854-863.

Your Heart and Nutrition

Your Heart and Nutrition

Prevention is better than a cure. Learn how to cherish your heart by taking the necessary means to keep it pumping healthily and steadily through your life.

Get My Free Ebook

Post a comment