Related Experiment Videos
[Ambulatory therapeutic noncompliance of the aged treated with digoxin]
R Cuena Boy1, M A Ortiz de Apodaca Ruiz
1Unidad de Farmacología Clínica, Hospital Virgen de la Salud, Complejo Hospitalario de Toledo.
Objective:
To quantify the percentage of out-patient doses (OPD) of Digoxin taken by elderly people in treatment.
Design:
An observational, longitudinal and retrospective study.
Setting:
Out-patient clinics at a geriatric hospital.
Patients:
67 patients were treated orally with Digoxin: 39 women; age 79 +/- 6; ideal weight, 55.7 Kg +/- 7.1; plasma creatinine, 1.3 +/- 0.9 mg/dl; in-hospital dose 3247.6 +/- 1309.4 ng/Kg; out-patient dose, 3205.7 +/- 1359.9 ng/Kg. They had two consecutive Digoxinemias, one in and one out of hospital, with an interval of 1 to 18 months between them.
Measurements And Main Results:
Therapeutic compliance was calculated by comparing the Digoxinemia/dose relationship per Kg of the ideal in-hospital weight against the non-hospital one. 37.3% of the patients ingested 80 to 110% of the OPD (95% CI, 26.7%-49.3%). The 36 patients on a constant dosage took 74.3% +/- 34.1% of the OPD, whereas the 31 not on a daily dose took 87.7% +/- 25.3% (P < 0.07).
Conclusions:
Non-compliance is common and hard to detect clinically. Therefore, it is dangerous to adjust the dose of non-compliant patients only on the basis of Digoxinemias or effects of the medicine, or on the doctor's view about compliance.