Influence of patient information leaflets on anticonvulsant drug compliance in prison

The effect of patient information leaflets on anticonvulsant drug compliance in a prison system was studied. Starting in January 1996, patient information leaflets were given to inmates in 18 prison units within the Texas Department of Criminal Justice who were receiving anticonvulsant medications. Nine of the units had pharmacist-operated chronic care clinics (POCs); the other nine did not. The units were matched on the basis of demographic characteristics and patient chronicity levels. Leaflet distribution continued until two weeks into March 1996. Certified medication aides (CMAs) watched inmates take doses and documented administration. A report on the anticonvulsant medications prescribed, dosage frequencies, number of patients taking each drug, and cumulative rate of compliance for each prison unit was generated monthly. The leaflets appeared to have a positive effect on compliance. The largest percent increases in compliance occurred on POC units, possibly because of the reinforcement provided by pharmacist counseling. The findings may have been affected by the integrity of the CMAs, the possibility that some patients on POCs did not receive pharmacist counseling, exploitation of the system by inmates for secondary gain, and other factors. Patient information leaflets may be of some use in increasing drug compliance in the prison population, but expectations must be tempered by the realities of this setting.