TREATMENT COMPLIANCE IN ADULTS WITH CYSTIC-FIBROSIS

Background- The study comprised three interrelated aims: (1) to ascert ain (a) patient compliance with physiotherapy, exercise, enzyme and vi tamin regimens, (b) how compliance was perceived by patients, and (c) the reasons for poor compliance; (2) to identify demographic and clini cal variables associated with compliance; and (3) to determine how acc urately patient compliance can be predicted by carers. Methods - Demog raphic and medical history data were obtained from medical records and a patient questionnaire. The data obtained included age, sex, employm ent status, inpatient or outpatient status, frequency of contact with the clinic, age at diagnosis, and the number of years practising physi otherapy. Measures of clinical status, including FEV(1) and FVC percen tage predicted, Shwachman score, and 24 hour sputum weight were record ed before completion of the questionnaire. The questionnaire, administ ered by a psychologist, assessed the reported degree of patient compli ance, their perception of compliance, and their reasons for poor compl iance. Results - Sixty patients participated in the study and 51/60 an d 41/55 patients were considered compliant with enzyme and exercise th erapies, respectively. Compliance was lower with physiotherapy (32/60) and vitamin treatment (21/ 45). Patients reporting immediate benefits following exercise and physiotherapy were more compliant than those r eporting no improvement. The perception by patients that compliance wa s sufficient (''about right'') was physiotherapy 67%, exercise 37%, en zymes 78%, and vitamins 9%. Compliance was not influenced by demograph ic details nor by severity of disease, although patients producing lar ge amounts of sputum and receiving help with physiotherapy were more c ompliant with physiotherapy. The physiotherapist and physician judged correctly the degree of compliance with physiotherapy in 83% and 75% o f cases, respectively, and with exercise in 68% and 67% of cases, resp ectively. Conclusions - The reported degree of compliance and reasons for poor compliance were treatment specific. Demographic and disease s everity variables were not associated with compliance. Those involved in the with cystic fibrosis were able to predict patient compliance.