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Compliance with anti-tuberculous therapy: a field trial of a pill-box with a concealed electronic recording device

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Summary

We have conducted a field trial of a pillbox containing a concealed electronic device for monitoring compliance in 23 consecutive adult out patients taking a rifampicin/isoniazid combination once daily. In 22 cases, the times when the box was opened were successfully recorded for the entire period (mean (SD) 26 (5) days) between successive clinic visits. In the other patient the record terminated after one week, a broken box being returned.

Both totality of compliance (as assessed by box openings) and consistency of compliance (the proportion of the total number of intervals between openings which were of 22 to 26 h in length) were significantly greater in those studied in the intensive than in the maintenance phase of therapy. Patients may have taken the reduction in medication at the end of the intensive phase as signalling cure.

A computer program has been developed to display the recorded data. This allowed the physician responsible to assimilate at a glance the patient's tablet-taking habits. In routine practice knowledge of the presence of the device may improve compliance and a discussion of the graphical display may prove of value in counselling.

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References

  1. Angel JH (1983) The case for short-course chemotherapy of pulmonary tuberculosis. Drugs 26: 1–8

    Google Scholar 

  2. Arnold AG, Curzon PGD, Page RL, Williams SE (1984) Non-compliance with antituberculous drugs. Br J Dis Chest 78: 295–298

    Google Scholar 

  3. Becker MH, Drachman RH, Kirscht JP (1972) A new approach to explaining sick-role behaviour in low-income populations. Am J Public Health 64: 205–216

    Google Scholar 

  4. Burkhardt KR, Nel EC (1980) Monitoring regularity of drug intake in tuberculous patients by means of simple urine tests. S Afr Med J 57: 981–985

    Google Scholar 

  5. British Thoracic Association (1976) Short-course chemotherapy in pulmonary tuberculosis. Lancet 2: 1102–1104

    Google Scholar 

  6. Chaulet P (1983) Synthesis on chemotherapy, bacteriology, prevention and surveillance of tuberculosis. Bull Int Union Tuberc 58: 26–36

    Google Scholar 

  7. Corcoran R (1986) Compliance with chemotherapy for tuberculosis. Ir Med J 79: 87–90

    Google Scholar 

  8. Dickins J, Cross G, Terry VG, Nicholson PW, Sullens CM, Cheung R, Denham MJ, Dobbs SM (1986) Measurement of compliance with drug therapy in the elderly: A new approach. Br J Clin Pharmacol 22: 246P

  9. Dixon WM, Stradling P, Wootton IDP (1957) Outpatient PAS therapy. Lancet 2: 871–872

    Google Scholar 

  10. Drug and Therapeutics Bulletin (1988) Chemotherapy of pulmonary tuberculosis in Britain 26: 1–4

  11. East African and British Medical Research Council (1979) Tuberculosis in Kenya: Follow-up of the second (1974) national sampling survey and a comparison with the follow-up data from the first (1964) national sampling survey. Tubercle 60: 125–149

    Google Scholar 

  12. Fox W (1962) General considerations in the choice and management of regimens of chemotherapy for pulmonary tuberculosis. Bull Int Union Tuberc 32: 307–331

    Google Scholar 

  13. Fox W, Mitchison DA (1975) Short-course chemotherapy for pulmonary tuberculosis. Am Rev Respir Dis 3: 325–353

    Google Scholar 

  14. Luntz GRWN, Austin R (1960) New stick test for PAS in urine. Br Med J 1: 1679–1684

    Google Scholar 

  15. Maddock RK (1967) Patient cooperation in taking medicines. J Am Med Assoc 199: 169–172

    Google Scholar 

  16. Monie RDH, Hunter AM, Rocchiccioli K, White J, Campbell IA, Kilpatrick GS (1982) Survey of pulmonary tuberculosis in south and west Wales (1976-8). Br Med J 284: 571–573

    Google Scholar 

  17. Moulding TS (1962) Proposal for a time recording pill dispenser as a method for studying and supervising the self-administration of drugs. Am Rev Respir Dis 85: 754–757

    Google Scholar 

  18. Moulding T, Onstad GD, Sbarbbaro JA (1970) Supervision of outpatient drug therapy with medication monitor. Ann Intern Med 73: 559–564

    Google Scholar 

  19. Moulding TS, Halper AR, Mkutu MP, Halper S (1974) Self-administration of isoniazid and thiazectone studied by medication monitor. Chest 65: 234–235

    Google Scholar 

  20. Norell S (1980) Medication behaviour — a study of outpatients treated with pilocarpine eye drops for primary openangle glaucoma. Acta Ophthalmol 143 [Suppl]: 1–28

    Google Scholar 

  21. Pamra SP, Prasad G, Mathur GP (1973) Causes of failure of domiciliary chemotherapy in pulmonary tuberculosis. Tubercle 54: 185–194

    Google Scholar 

  22. Pearce SJ, Horne NW (1974) Follow-up of patients with pulmonary tuberculosis adequately treated by chemotherapy: Is this really necessary? Lancet 2: 641–643

    Google Scholar 

  23. Preston DF, Miller FL (1964) The tuberculosis outpatient's defection from therapy. Am J Med Sci 247: 21–24

    Google Scholar 

  24. Singapore Tuberculosis Service/British Medical Research Council (1977) Controlled trial of intermittent regimens of rifampicin plus isoniazid for pulmonary tuberculosis in Singapore. Am Rev Respir Dis 116: 807–820

    Google Scholar 

  25. South-East Metropolitan Region Thoracic Society (1973) Relapse in tuberculosis. Br J Dis Chest 67: 33–42

    Google Scholar 

  26. Velu S, Andrew RH, Devadatta S, Fox W, Radhakrishna S, Ramakrishnan CV, Selkon JB, Somasundaram PR, Subbaiah TV (1960) Progress in the second year of patients with quiescent pulmonary tuberculosis after a year of chemotherapy at home or in a sanatorium and influence of further chemotherapy on the relapse rate. Bull WHO 23: 511–533

    Google Scholar 

  27. Wynn-Williams N, Arris M (1958) On omitting PAS. Tubercle 39: 138–142

    Google Scholar 

  28. Zaki MH, Edelstein S, Josephson RA, Weisberg SR (1968) Regularity of drug administration among hospitalized and ambulatory tuberculous patients. Am Rev Respir Dis 97: 136–139

    Google Scholar 

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Cheung, R., Dickins, J., Nicholson, P.W. et al. Compliance with anti-tuberculous therapy: a field trial of a pill-box with a concealed electronic recording device. Eur J Clin Pharmacol 35, 401–407 (1988). https://doi.org/10.1007/BF00561372

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  • DOI: https://doi.org/10.1007/BF00561372

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