Compliance in children and adults: review of studies

Adherence to prescribed medication, or patient compliance, was studied over a period of several years in 3 populations with seizure disorders: 2 pediatric (n = 90, n = 211), and 1 adult population (n = 177). Compliance was assessed in several different ways: self-reports and serum levels analyzed for the level/dose ratio as well as the coefficient of variation for each patient. Correlates studied included Health Belief Model variables as well as internal locus of control, social support, knowledge about seizures and other variables. The assessed extent of compliance ranged from 54% to 82% in the various groups. Overall, compliance was related to motivation, value of illness threat reduction, and probability that compliant behavior will reduce the threat. Also related to compliance were some measures of the following types of variables: demographic, structural, attitudinal, provider/patient interaction, social support, experience with the regimen, internal control, and knowledge. A group discussion intervention designed to enhance compliance was implemented and evaluated effectively in the pediatric seizure population. In the adult population, compliance and seizure control both increased over a 2 year follow-up period, but were not significantly related.