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Report on improving patient compliance with medicines

9 Apr 2001

Research published in journal Neurology investigates the link between simple directions for the taking of drugs and the likelihood of the medication being taken correctly.

Doctors know patients are more likely to take their medications as prescribed if the directions are simple and easy to follow. A common drug for epilepsy, gabapentin, however, calls for patients to begin the therapy with a 300mg dose on the first day of initiation, followed by 60mg on day two, then 900mg each day after that, presumably to reduce side effects such as sleepiness, dizziness, muscle coordination, and fatigue.

Noting that the drug has been given safely to some patients in doses of up to 4,800mg a day, researchers, led by a group from the Epilepsy Center at Stanford Medical School, decided to see if gabapentin could be just as easily tolerated by patients if they started with the 900mg a day dose.

The study enrolled male and female patients with a recent history of partial seizures who were at least 12 years of age. Subjects were divided into two groups. One group received gabapentin according to the traditional dosing recommendations. The other group was started on the drug at the 900mg a day dose and remained on that dosage over the one-week study period.

Results showed that patients who started out with the 900mg dose experienced similar rates of side effects as those who worked up to that dose over three days in terms of muscle coordination, sleepiness and fatigue. However, this group did experience a greater degree of dizziness. Interestingly, the increased incidence of dizziness in this group did not lead to greater discontinuation of the drug. Of the four patients in the study who quit taking the medication because of dizziness, three were in the traditional dosing group and only one was in the group that began on the 900mg dose.

Although the researchers say their study was not long enough to come to any specific conclusions, they suggest that the easier dosing requirements may have led to better overall compliance in the 900mg a day group.