Assessment of Dosage Deviation In Outpatient Drug Research

¹ Philadelphia General Hospital; University of Pennsylvania.
² Philadelphia General Hospital.

A review of the literature reveals three methods commonly employed for measuring dosage deviation : urine analyses, pill counts of medication remaining after a period of treatment, and patients' verbal reports of medication taken. Researchers have found urine analysis limited as an indication of degree of deviation despite its objectivity and the verbal report inaccurate in comparison to both urine tests and pill counts. Some evidence suggests that verbal reports are more accurate in cases of major deviation. Six hundred and seventy-five pill counts and verbal reports were compared for neurotic outpatients grouped according to population (hospital clinic and general practice), drug, and number of pills making up their daily dosage. Across these groups verbal reports generally indicated less deviation from prescribed dosage than did pill counts. Discrepancies between the two measures occurred most often when deviation was slight and relatively infrequently when deviation was large. Though generally less accurate, verbal reports do not appear to be seriously in error when deviation is large.

Note:

The authors wish to express their appreciation to Drs. E. L. Clark, F. J. Phillips, and L. Sablosky, who collected the private practice data, as well as to the many physicians from the Psychopharmacology Research Unit of Philadelphia General Hospital who contributed data for this study.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				R. Holland, I. Brooksby, E. Lenaghan, K. Ashton, L. Hay, R. Smith, L. Shepstone, A. Lipp, C. Daly, A. Howe, et al. Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomised controlled trial BMJ, May 26, 2007; 334(7603): 1098 - 1098. [Abstract] [Full Text] [PDF]

				S. A Vik, C. J Maxwell, and D. B Hogan Measurement, Correlates, and Health Outcomes of Medication Adherence Among Seniors Ann. Pharmacother., February 1, 2004; 38(2): 303 - 312. [Abstract] [Full Text] [PDF]

				G. C. Lamb, S. S. Green, and J. Heron Can Physicians Warn Patients of Potential Side Effects Without Fear of Causing Those Side Effects? Arch Intern Med, December 12, 1994; 154(23): 2753 - 2756. [Abstract] [PDF]

				S. A. ERAKER, J. P. KIRSCHT, and M. H. BECKER Understanding and Improving Patient Compliance Ann Intern Med, February 1, 1984; 100(2): 258 - 268. [Abstract] [PDF]