Springer Online Journal Archives 1860-2000
Chemistry and Pharmacology
Summary The drug history of 285 consecutive patients admitted to two medical wards of a Swedish university hospital was investigated. In 30 cases (11%) no information about current drug therapy could be obtained from the patients themselves, and in further 21 (7%) additional drugs from other sources were discovered. Current drug therapy of 234 patients (82%) was identified, of whom 217 had medicines supplied by prescription and 52 used drugs bought over the counter. The medication was “chronic” for 85% of the prescribed drugs, and 18% were prescribed to be taken as required. Significantly more women than men were taking medicines, but, amongst the users, there was no significant difference in the number of drugs taken by men or women. The average number of drugs prescribed for the 217 patients was 3.7, more being prescribed for the older patients. Cardiovascular and psychotropic medicines were the agents most commonly prescribed. Digoxin was prescribed for 65 patients. The mean daily dose was 0.20 mg, and it was reduced for older patients and for those with elevated serum creatinine. Twelve patients (19%) had no measurable digoxin in their plasma; the median concentration was 1.15 nmol/l. Ten of 32 patients (31%) had a significant change in their plasma digoxin concentration after supervised drug intake in hospital, indicating previous irregular intake of digoxin. Compliance with the prescribed drug regimen was evaluated from interviews of 151 patients. Of them, 59 (39%) were classified as having been non-compliant for half their drugs during the last two days prior to admission. Non-compliance was reported significantly more often by patients who were aged 65 years or more, and who had more than three drugs prescribed for regular intake. The number of drugs prescribed did not seem to influence compliance in patients under 65 years of age. Significantly more doses were reported to be missed for drugs meant to be taken thrice daily (31%), than for those with once (18%) or twice (20%) daily dosage schedule. The difference between once and twice daily schedules was not significant.
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