Improving Patient Compliance With Treatment Regimens By Using Novel Drug Delivery Systems
The Importance of Taking Medication Properly
If you have a health problem and your doctor prescribes medication, you should take the medication exactly as directed. This is true for an acute illness such as a sore throat or for a chronic condition such as hypertension. Patient non-compliance with the drug regimen is one of the most prominent impediments to the successful treatment of chronic conditions. Other negative consequences of patient non-compliance include a decline in the patient's health, additional hospitalizations and significant increases in the cost of healthcare. According to "The Merck Manual Home Health Handbook," about 25% of nursing home admissions, 10% of hospital admissions and numerous doctor visits and diagnostic tests could be avoided if patients took their medications as directed by their doctor.
Reasons For Patient Non-Compliance
There are a number of reasons why patients may not take their medication exactly as prescribed. In some cases, the patient can't afford the high cost of the drug, and therefore decides to reduce the number of doses. Patients who have difficulty swallowing may find it too frustrating to take conventional tablets and pills. If the side effects of the medication are particularly unpleasant, the patient may be tempted to skip the dosing. The relationship between doctor and patient also factors into the patient's compliance with drug therapy. A patient who does not trust his or her doctor's judgment, is more likely to be careless when it comes to taking prescribed medication. Patients who take several different medications may become confused and lose track of which drugs have been taken on a given day. If the patient finds that the instructions for taking the drug are too complicated and the drug needs to be taken too frequently, he or she may decide not to bother with treatment. Some patients don't take their medication properly because they are in denial about the seriousness of their illness. Finally, some drug therapy regimens require that the patient avoid sunlight, alcoholic beverages or milk products. Patients who find these restrictions too burdensome may simply not comply with treatment.
How Novel Drug Delivery Systems Help With Patient Compliance
Manufacturers of drug technology have taken note of the problem of patient non-compliance with drug therapy regimens. They have come up with new ways of delivering drugs, and these new methods greatly facilitate patient compliance. Advances in oral delivery, for example, have led to sustained-release formulations that reduce the frequency of dosing and attenuate side effects by limiting the maximum amount of drug that gets into the bloodstream. An example of this is metformin XL, a once-a-day, sustained-release formulation of the most commonly prescribed oral drug for type 2 diabetes. In a clinical study published in the April 2009 edition of "Diabetes, Obesity and Metabolism," researchers conclude that patients who took metformin XL had significantly better compliance rates than those who took the conventional metformin immediate release formulation. The researchers recommend that patients who can't tolerate the gastrointestinal side effects of conventional metformin should try metformin XL. In addition, in a paper published in the November 2008 edition of "Recent Patents on Drug Delivery and Formulation," researchers note that recently developed rapidly disintegrating oral formulations including tablets and films have led to very high rates of compliance particularly among geriatric and pediatric patients. Patients who have difficulty with swallowing prefer these rapidly disintegrating formulations because they can't drink a large quantity of water in a short time.
The discovery of biodegradable polymers has allowed the development of implants that can deliver a sustained release of drug. EyeDocNews.com, a website on which leading ophthalmologists provide eye care professionals with the latest information on new treatments, reported on a drug implant for glaucoma. In a June 2011 article, the website disclosed the start of a phase I/II clinical study of the biodegradable drug delivery implant that will provide a long-term sustained release of the drug latanoprost. This drug treats glaucoma by reducing the pressure inside the eye. The implant will be injected into the space between the sclera or white of the eye and the lower eyelid, and should provide treatment for several months. Many glaucoma patients don't comply with treatment because they have difficulty administering their medication in the form of eye drops. If the clinical trial is successful, the implant would address this serious problem of non-compliance with treatment.
There have also been advances in the delivery of drugs through the skin known as transdermal delivery. The July/August 2011 issue of "Drug Development and Delivery" reports on the development of the PassPortTM transdermal drug delivery system by Altea Therapeutics Corporation. This system is designed to deliver drugs into the bloodstream from a safe, painless and easy-to-use transdermal skin patch. The drugs pass through micropores created in the outermost layer of the epidermis. Currently, Altea is engaged in clinical studies of four drugs using the PassPort delivery system. These drugs include enoxaparin sodium for the treatment of blood clots, exenatide for type 2 diabetes, insulin for type 1 and type 2 diabetes and fentanyl citrate for chronic pain. All four of these drugs are currently administered by injection. Patients with diabetes don't always fully comply with exenatide and insulin treatment regimens because they may find the injections difficult to tolerate. The PassPort system should improve patient compliance with these drug therapies.
Patient Compliance and Patient Education About the Treatment
This hub has been written for the sole purpose of providing information to the reader. It is not intended as a source of any kind of medical advice or instruction, and it should not be used in the diagnosis of any illness, disease or condition. You should consult your doctor if you have questions about a specific medical problem.