Skip to main content
Log in

Once a Day is Best: Evidence or Assumption?

The Relationship Between Compliance and Dosage Frequency in Older People

  • Review Article
  • Drug Therapy
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

To rationalise medication in the elderly, physicians often change multiple dose regimens to once daily in the belief that this improves compliance. Effective methods for measuring compliance have only come into use during the last decade. Partly as a result of this, high quality studies comparing once daily with other regimens in the elderly, are lacking. What evidence there is, from investigations which used suboptimum methods and/or mixed (elderly/younger) patient groups, does not justify the widely held view that ‘once a day is best’, particularly when compared with twice daily regimens.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Government Actuary Department. Population projections 1994–2064: population projection by sex and age for Great Britain prepared by the government actuary in consultation with the registrar general. London: Government Actuary Department, 1996

    Google Scholar 

  2. Gatley MS. To be taken as directed. J R Coll Gen Practit 1968; 16: 39–44

    CAS  Google Scholar 

  3. Office of Population Censuses and Surveys. Living in Britain: results from the 1994 general household survey Supplement A: people aged 65 and over. London: Office of Population Censuses and Surveys, 1994

    Google Scholar 

  4. Marten J, Meltzer H, Elliot D. The prevalence of disability among adults. London: Her Majesty’s Stationery Office, 1989. (Office of Population Censuses and Surveys survey of disabiltiy in Great Britain; report no.: 1)

    Google Scholar 

  5. Porter AMW. Drug defaulting in a general practice. BMJ 1969; 1: 218–22

    Article  PubMed  CAS  Google Scholar 

  6. Taggart AJ, Johnston GD, McDevitt DG. Does the frequency of daily dosage influence compliance with digoxin therapy? Br J Clin Pharmacol 1981; 1: 31–4

    Article  Google Scholar 

  7. Greenburg RN. Overview of patient compliance with medication dosing: a literature review. Clin Ther 1984; 6: 592–9

    Google Scholar 

  8. Pullar T, Birtwell AJ, Wiles PG, et al. Use of a pharmacological indicator to compare compliance with tablets prescribed to be taken once, twice or three times daily. Clin Pharmacol Ther 1988; 44(5): 540–5

    Article  PubMed  CAS  Google Scholar 

  9. Cramer JA, Mattson RH, Prevey ML, et al. How often is medication taken as prescribed? A novel assessment technique. JAMA 1989; 261: 3273–7

    Article  PubMed  CAS  Google Scholar 

  10. Brun J. Patient compliance with once daily and twice daily oral formulations of 5-isosorbide mononitrate: a comparative study. J Int Med Res 1994; 22: 266–72

    PubMed  CAS  Google Scholar 

  11. Detry JMR, Block P, Backer G, et al. Patient compliance and therapeutic coverage: amlodipine versus nifedipine (slow’ release) in the treatment of angina pectoris. J Int Med Res 1994; 22: 278–86

    PubMed  CAS  Google Scholar 

  12. Waeber B, Erne P, Saxenhofer H, et al. Use of drugs with more than a twenty four hour duration of action. J Hypertens 1994; 12Suppl. 8: S67–71

    CAS  Google Scholar 

  13. Atkin PA, Finnegan TP, Ogle SJ, et al. Functional ability of patients to manage medication packaging: a survey of geriatric inpatients. Age Ageing 1994; 23: 113–6

    Article  PubMed  CAS  Google Scholar 

  14. Burns E, Austin CA, Bax NDS. Elderly patients understanding of their drug therapy: the effect of cognitive function. Age Ageing 1990; 19: 236–40

    Article  PubMed  CAS  Google Scholar 

  15. Lowe CJ, Raynor DK, Courtney EA, et al. Effects of self medication programme on knowledge of drugs and compliance with treatment in elderly patients. BMJ 1995; 310: 1229–31

    Article  PubMed  CAS  Google Scholar 

  16. Darnell JC, Murray MD, Martz BL, et al. Medication use by ambulatory elderly: an in home survey. J Am Geriatr Soc 1986; 34: 1–4

    PubMed  CAS  Google Scholar 

  17. Black DM, Brand RJ, Greenlick M, et al. Compliance to treatment for hypertension in elderly patients: the SHEP pilot study. J Gerontol 1987; 42: 552–7

    PubMed  CAS  Google Scholar 

  18. Pullar T, Kumar S, Tindall H, et al. Time to stop counting the tablets? Clin Pharmacol Ther 1989; 46: 163–8

    Article  PubMed  CAS  Google Scholar 

  19. Rudd P, Byyny RL, Zachary V, et al. The natural history of medication compliance in a drug trial: limitations of pill counts. Clin Pharmacol Ther 1989; 46: 169–76

    Article  PubMed  CAS  Google Scholar 

  20. Hardy E, Kumar S, Peaker S, et al. A comparison of a short half-life marker (low dose isoniazid), a long half-life pharmacological indicator (low dose phenobarbitone) and measurements of a controlled release therapeutic drug (metoprolol) in reflecting incomplete compliance by volunteers. Br J Clin Pharmacol 1990; 30: 437–41

    Article  PubMed  CAS  Google Scholar 

  21. Pullar T, Peaker S, Martin MFR, et al. The use of a pharmacological indicator to investigate compliance in patients with a poor response to antirheumatic therapy. Br J Rheumatol 1988; 27: 381–4

    Article  PubMed  CAS  Google Scholar 

  22. Patient compliance in therapeutic trials [editorial]. Lancet 1991; 337(6): 823–4

    Google Scholar 

  23. British National Formulary 1997. Prescribing for the elderly. London: British Medical Association/Royal Pharmaceutical Society of Great Britain, 1997

    Google Scholar 

  24. Williams L, Lowenthal DT. Drug therapy in the elderly. South Med J 1992; 82(2): 127–31

    Article  Google Scholar 

  25. Kruse W, Rampmaier J, Ullrich G, et al. Patterns of drug compliance with medications to be taken once and twice daily assessed by continuous electronic monitoring in primary care. Int J Clin Pharmacol Ther 1994; 32(9): 452–7

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Morgan Feely.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pushpangadan, M., Feely, M. Once a Day is Best: Evidence or Assumption?. Drugs Aging 13, 223–227 (1998). https://doi.org/10.2165/00002512-199813030-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-199813030-00005

Keywords

Navigation