Investigation of Outpatients' Compliance with Medication After Meal and Analysis of Factors on their Noncompliance.

Abstract

We investigated the outpatients' understanding and compliance with taking “medication after meals”, a typical timing of medication, and examined the factors influencing patients' noncompliance. The subjects (35 men and 69 women, aged 56±8) were randomly chosen from the outpatients at Tokyo University Hospital, to whom a drug listed in our active guidance system as “ medication required after meal” had been prescribed at a community pharmacy. The patients were interviewed at the outpatient counter to examine the following points: 1) whether they understood and actually took the medications after meals, 2) whether or not they routinely having breakfast, 3) when and why some patients cannot comply with taking medications after meals, and 4) whether or not they had received drug compliance instructions at community pharmacies and if so what instructions were received. As a result, almost all patients (97%) understood that they have to take particular medicines “within 30 min after meals”, but approximately 30% of the patients failed to do so, indicating a discrepancy between the patients' understanding and actual compliance. The occurrence of noncompliance was as high as 47% after lunch and 21% after breakfast, and the major reason for the former case was time restrictions due to work or going out, thus suggesting the need to consider the patients' life style when pharmacists give instructions. 61 % of the patients answered that they have not received compliance instructions at community pharmacies; the ratio of those who have not received compliance instructions at community pharmacies was 52% among the patients who corrected took the drugs after meals, but 71% among the patients who sometimes failed to take the drugs correctly (one-sided P<0.05;χ2 test), thus suggesting the importance of giving compliance instruction at community pharmacies. In conclusion, our study suggested that pharmacists need to make greeter efforts to instruct patients, such as a more individualized instructions based on the lifestyle of each patient, in order to improve patients' compliance with medication after meals and thus to promote the rationaluse of medicine.