Is This Patient Taking the Treatment as Prescribed?

TLDR

Asthma and posttraumatic seizure disorder are chronic conditions that rely on regular inhaled β2‑agonist, inhaled steroid, or phenytoin therapy. The study emphasizes that physicians should assess medication adherence in self‑administered therapies to address common noncompliance and enhance treatment benefits. Patients frequently report occasional missed doses, yet some deny noncompliance, and overall long‑term adherence to self‑administered therapy is roughly 50%.

Abstract

<h3>CLINICAL SCENARIOS</h3><h3>Case 1</h3> A 28-year-old woman presents to the emergency department in acute distress with a 3-day history of worsening asthma. Her prescribed medications include an inhaled β₂-agonist and an inhaled steroid. When questioned, she breathlessly admits to "occasionally" missing her medications but indicates that this is "maybe only once or twice." <h3>Case 2</h3> A 55-year-old man with posttraumatic seizure disorder has been taking phenytoin since his injury. His seizures were initially adequately controlled but he recently has been having weekly seizures. In an office visit he resentfully denies missing any of his medication. <h3>THE IMPORTANCE OF CLINICAL EXAMINATION</h3> Physicians should measure compliance for patients prescribed a self-administered treatment because noncompliance is common and physicians can help patients to improve their compliance^1,2and increase the benefit they derive from therapy. Compliance with long-term self-administered medication therapy is approximately 50% for those who remain in care.³