The problem of patient compliance with treatment for respiratory infections

Abstract

Patient compliance describes the degree, to which a patient follows treatment regimen. At present, non-compliance with medical recommendations is one of the key problems for outpatient practice. Even in case of respiratory infections, patients often violate the prescribed treatment regimen, which leads to growth of ineffective treatment cases, complications, and is also accompanied by a high risk of selection of drug-resistant infectious organisms and rise in expenditures for managing patients. The most common mistakes made by patients include the change by patients of the prescribed antibiotic dosing regimen and premature termination of antimicrobial therapy. Factors affecting patient compliance are extremely diverse. Among them are factors associated with treatment and a disease, patient-associated factors of «doctor - patient» contact, and demographic predictors of low compliance, drug dosage frequency. The most important factors affecting adherence to treatment are duration of therapy; drug tolerance/safety; dosage forms (tablets, syrup, sachet); patient confidence in medical recommendations (presence of «doctor - patient» relationship); severity of the disease; patient age and sex; social activity/employment of the patient; social status of the patient, level of education; marital status; presence of a concomitant pathology in the patient; presence of bad habits (smoking, alcohol) in the patient. The main factor affecting the compliance with therapy is the drug dosage frequency. It is known that compliance is highest, if a patient is required to take a single dose of the drug per day. Duration of therapy is another important factor affecting the patient compliance. For instance, pharmacotherapy for 7 days is characterized by better compliance compared to longer antibiotic treatment regimens. Methods of improving compliance with antimicrobial therapy: reduction in the drug dosage frequency; short courses of antibiotic therapy; favourable safety profile; the cost of the drug; a patient-friendly form of antibiotic dosage form; patient education, clear information of the patient; monitoring the treatment process (repeat visits, phone contacts, etc.). The most effective way to increase compliance is to use an antibiotic drug 1-2 times per day. The use of short antibiotics courses (less than 7 days) is also a good way to increase adherence to treatment. The use of antibiotics with a good safety profile is another important approach to improving the compliance. The article also discusses other ways to enhance the patient compliance with the treatment for respiratory infections.