The use of a pharmacological indicator to investigate compliance in patients with a poor response to antirheumatic therapy

Br J Rheumatol. 1988 Oct;27(5):381-4. doi: 10.1093/rheumatology/27.5.381.

Abstract

Twenty-six patients with rheumatoid arthritis which was poorly controlled despite high dose D-penicillamine were studied. Compliance was assessed by standard methods (return tablet count and interview). In addition low-dose phenobarbitone was included in the penicillamine formulation as a pharmacological indicator of compliance. Using these techniques incomplete compliance was apparent in 11 patients (42%). All such patients were identified by the pharmacological marker. Only one admitted poor compliance at interview and only six returned more than a few tablets too many. The reason for the high incidence of poor compliance in this selected group is not apparent but it may represent a significant cause of failure with D-penicillamine therapy. The use of low-dose phenobarbitone may have wider applications in the investigation of patients with other conditions who fail to respond adequately to treatment.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / drug therapy*
  • Humans
  • Middle Aged
  • Monitoring, Physiologic
  • Patient Compliance*
  • Penicillamine / therapeutic use
  • Phenobarbital / blood

Substances

  • Penicillamine
  • Phenobarbital