Incidence of Noncompliance and its Influencing Factors in Patients Receiving Digoxin
Tóm tắt
Objective: Patient noncompliance with drug therapy is one of the major problems in the successful management of chronic diseases. The present study was designed to clarify the incidence of noncompliance in 843 patients (518 inpatients; 325 outpatients) and its influencing factors in outpatients receiving digoxin for congestive heart failure and/or atrial fibrillation with tachycardia.
Patients and Methods: The serum digoxin concentration (SDC) was used to evaluate the medication noncompliance of patients. Patients were defined as noncompliant when their SDC was measured as zero on at least three occasions.
Results: The incidence of noncompliance in inpatients and outpatients was 4.2 and 22.2%, respectively. In 55 selected patients who responded to digoxin therapy and showed an attenuation of both tachycardia and the gain in bodyweight, and a disappearance of symptoms of heart failure during their hospitalisation, the incidence of noncompliance was 18.2% 6 months after discharge. All of these noncompliant patients had received nonsurgical treatment. Amongst the entire group of 325 outpatients, the incidence of noncompliance with past surgical treatment was significantly lower than in outpatients without it. Longer office visits, increased number of office visits and better understanding of medication used and illness were associated with a lower incidence of noncompliance in the 325 outpatients.
Conclusions: Incidence of noncompliance in outpatients with digoxin therapy is affected by surgical treatment, duration and number of office visits, and understanding of the medication used to treat patients and the illness. Additionally, this result suggests that factors associated with surgical treatment, such as the duration of office visits, may play a significant role in mitigating the rate of noncompliance in outpatients.
Tài liệu tham khảo
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