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An evaluation of compliance in cancer patients and non-insulin dependent diabetics.

Lee, Cynthia Rhoda; (1992) An evaluation of compliance in cancer patients and non-insulin dependent diabetics. Doctoral thesis (Ph.D.), School of Pharmacy. Green open access

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Abstract

A novel electronic recording device for monitoring patient compliance with oral therapy was described and the method of its construction explained. The accuracy of the device under various conditions of use was evaluated. To interpret the output data from the monitor new compliance measures were devised describing the "overall compliance", the "daily irregularity" and the "hourly irregularity". The device was used to assess the compliance in three groups of patients attending out-patient oncology clinics in London hospitals. These patients were suffering from small-cell lung cancer, or ovarian cancer or lymphoma. The influence on patterns of drug administration of factors such as their quality of life, including experience of drug side-effects, the number of cycles of chemotherapy they had received and the complexity of their dosage regimens was considered. In a further study, a group of non-insulin dependent diabetics were recruited from two general practice surgeries in London. They were all being treated with the oral hypoglycaemic agent glibenclamide. Their compliance was assessed using the electronic monitor, by blood levels of the drug, by the physicians' estimation and by counting the number of tablets returned in the device at each visit. Possible correlations between compliance and the patients' health beliefs and biochemical measures of diabetes control were investigated. Patient compliance with the short term courses of oral chemotherapy was found to be very high in all the patient groups and suggests that inadequate compliance with oral chemotherapy would not account for any significant lack of clinical response in these patients. This finding inspires confidence in the use of self-administered oral chemotherapy, having as it does advantages in convenience to the patient and cost of treatment. More surprisingly, compliance with long term oral hypoglycaemic agents was also found to be high and reasons for this are discussed. The ethics and advantages of using electronic devices to monitor compliance are discussed in the light of these findings.

Type: Thesis (Doctoral)
Qualification: Ph.D.
Title: An evaluation of compliance in cancer patients and non-insulin dependent diabetics.
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by Proquest
URI: https://discovery.ucl.ac.uk/id/eprint/10108098
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