Life-style and medication compliance in elderly patients.

Views of elderly patients and their relatives on cardiopulmonary resuscitation. SIR—The results presented by Minors et al. that older subjects showed less day-today variation in life style as obtained from diary reports [1] correspond to findings revealed by compliance monitoring. This indirect assessment method, continuous electronic compliance monitoring, provides information about the actual time history of patients' medication dosing [2, 3]. Different aspects of medication compliance—drug consumption , adherence to the prescribed regimen, and timing-compliance as a measure of regular drug use — can be expressed quantitatively. Maillon et al., using compliance monitoring in 590 hypertensive patients prescribed a QD regimen, recorded significantly fewer delayed doses in patients over 60 than those under 60 [4]. They also found significantly lower compliance on weekends than during the week, as had been shown by our group [5]. This finding was confirmed again in a recent study in which drug compliance with a QD (amlodipine) and a BID regimen (nifedipine) was monitored in patients with mild to moderate hypertension for a period of 6 months [6]. Mean non-correct dosing, as a measure of non-compliance of 94% (95% CI 8.0;11.2) during the week increased to 10.6% (95% CI 9.0; 12.4) on weekends (P< 0.024). However, in the elderly patients (n = 53, mean age 699 ± 3.8 years, range 65-80), 9.2% non-compliance during the week decreased to 8.5% on weekends (n.s.) while the younger patients (n = 166, mean age 54.2 ± 6.5 years, range 40-64 years) showed an increase from 9.5% non-compliance on weekdays to 11.4% on weekends (P= 0.002). In general, the elderly patients took the prescribed medicine more regularly, as indicated by 1239/1304 doses (95%) recorded between 0700 h and 0959 h compared with the younger patients with 3511/4333 doses (81%) for the QD regimen. This held true for the BID regimen, where 1971 and 1711 doses (91.7%) were recorded in the elderly group between 0700 h and 0959 h and 1900 h and 2159 h, compared with only 3083 and 2195 doses (75 7%) in the younger patients. Furthermore, non-compliance was twice as high with the evening than with the morning dose in the younger patients, while the elderly subjects showed no significant difference in compliance between the two doses. Drug use may well correspond to elderly people's regular patterns of lifestyle. In improving drug compliance , 'routine' daily activities have to be considered as cues for regular medication use. …