Simplifying dosage boosts adherence

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The problem: Between 20% and 50% of patients fail to adhere to their medical therapy. The best solution: Simplify their dosages.

Over the years, investigators have tested everything from patient handouts to complex motivational programs involving numerous types of health professionals, all to find ways to get patients to take their meds. Instead of undertaking yet another study, a team of researchers at Emory University in Atlanta analyzed all the data accumulated so far.

Their global search turned up 37 randomized, controlled trials published between 1967 and 2004. Only 20 reported a significant improvement in patient adherence. In general, efforts focusing on changing behavior were more effective than those that involved social support or supplying information, either with handouts or staff instruction.

Simplifying dosage demands—such as switching from two doses to one or from four to two per day—was the only intervention that consistently improved compliance. Several other interventions, however, including multisession educational counseling, monitoring and feedback, and rewards, among others, also prompted some patients to become more compliant (Arch Intern Med. 2007; 167:540-550).

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