COMPLIANCE WITH TREATMENT IN ADULT PATIENTS WITH CYSTIC-FIBROSIS

Background - Patients with chronic disease comply with about 50% of th eir treatment. The complex and time consuming daily drug regimens need ed in the care of adult patients with cystic fibrosis encourage non-co mpliance with prescribed treatments. Understanding the reasons for, an d the extent of, non-compliance is essential for a realistic appraisal of the patient's condition and sensible planning of future treatment programmes. Methods - Patients were invited to complete a questionnair e which asked about their compliance with daily treatment. The data we re used to calculate a compliance score, the percentage of prescribed treatment taken, and to examine patient attitudes to each individual p rescription. An assessment score derived from consultant, cystic fibro sis research fellow, specialist nurse, and physiotherapist ratings of patient compliance was compared with the compliance score. Both scores were correlated with patient characteristics and disease severity, an d the compliance score was also correlated with the patient's knowledg e of cystic fibrosis. Results - More than half the patients claimed to take more than 80% of their treatments. Compliance with individual tr eatments varied according to their perceived unpleasantness and degree of infringement on daily activities. The most common reason given for omitting treatment was forgetfulness. Professional carers were poor j udges of patient compliance. There was no correlation between complian ce and patients' sociodemographic characteristics or their knowledge a bout cystic fibrosis. Conclusions - Non-compliance is universal and sh ould be recognised as normal behaviour. There are no reliable criteria for predicting any patient's level of compliance. Treatment protocols should be planned around individual patient's requirements, modifying treatment ideals where necessary according to the exigency and patter n of that patient's lifestyle.