A reliable method for evaluating drug compliance in children with cancer

Cancer. 1979 Jan;43(1):169-73. doi: 10.1002/1097-0142(197901)43:1<169::aid-cncr2820430125>3.0.co;2-f.


Poor drug compliance may cause a decreased survival of children with malignancies. Children who fail to take their medications are not receiving optimum amounts of chemotherapy and suboptimal therapy causes a shortened survival in children with cancer. This is a study of prednisone compliance in 52 children with cancer during three distinct phases of therapy. The patients were either known to be taking prednisone (on-therapy group), off prednisone (off-therapy group), or their compliance was unknown (unknown group). Evaluation of prednisone compliance was attempted by measuring hemoglobin level changes, weight changes, and random urinary 17-ketogenic steroids. The results obtained show that while hemoglobin and weight changes are not helpful, a random urine 17-ketogenic steroid assay is able to differentiate clearly those patients who are taking their prednisone. By the use of this assay it was found that 33% of patients who by protocol and instruction were supposed to be receiving prednisone were not complying. Separate analysis of adolescents revealed an even more alarming 59% noncompliance rate. This striking level of noncompliance strongly suggests that the survival of patients may be threatened by noncompliance.

MeSH terms

  • 17-Ketosteroids / urine
  • Adolescent
  • Body Weight / drug effects
  • Child
  • Child, Preschool
  • Female
  • Hemoglobins / analysis
  • Humans
  • Infant
  • Leukemia / analysis
  • Leukemia / drug therapy*
  • Leukemia / pathology
  • Male
  • Patient Compliance*
  • Prednisone / adverse effects
  • Prednisone / therapeutic use*
  • Prognosis


  • 17-Ketosteroids
  • Hemoglobins
  • Prednisone