FAILURE TO OBSERVE DOSAGE INSTRUCTIONS IN PATIENTS WITH EPILEPSY: The short‐term effect of a daily dispenser

This is an investigation of the short-term effect of using a daily dispenser in the treatment of outpatients with epilepsy. The finding of other authors that there is no correlation between the dose of diphenyl-hydantoin (DPH) pr kg body weight and the plasma DPH was confirmed. Nor was such correlation found 3 and 4 weeks, respectively, after supplying information on the importance of regular intake of medicine or the provision of the daily dispenser. A significant increase was found in the level/dose ratio of DPH in the group using the daily dispenser, by comparison with a control group not receiving the pack. The variance of the difference between two level/dose ratios determined at an interval of a week was significantly less in the group with the dispenser. The interpretation of these findings is that the daily dispenser results in an increased and stabilized intake of medicine. In addition, the relationship was examined between a number of presumably motivating data and the primary DPH level/dose ratio. Single factors were not found to be significantly correlated to this, but a clear positive correlation was demonstrated between the number of negatively motivated environmental factors and a high plasma level, as well as a large variance in the difference between the two primary level/dose ratios. This may be explained by the negatively motivated patient having an irregular intake of medicine, which may result not only in too little, but also in too great an intake of medicine. The investigation underlines how important it is that the physician administering the treatment be aware of the influence of environmental factors on the regularity with which medicine is taken. Information of medicine plus the daily dispenser, or these factors separately, results in a significantly greater rise in the level/dose ratio in a group of patients with normal memory than in a group with impairment of memory.