Therapeutic compliance of patients on phenothiazines.

SUMMARY The present study was designed to assess the therapeutic compliance of psychiatric patients who re­ ported to be o"i regular medication particularly phenothiazines. Of the all cases subjected to the F.P.N, test, it was clearly negative in 21 (18.9 %) indicating, their non-adherence to the drug therapy. Despite their report of regular drug intake at the time of urine screening, five of these twenty one patients had reported at a later date discontinuity cf therapy fcr some reason or the other. Curiously, on a long term drug therapy, the incidence of non-complianc e is relatively less. One of the striking impediments in the implementation of the treatment pro­ gramme of psychiatric patients is the pro­ blem of non-adherence to medication. It encompasses a wide variety of behaviors on the part of the patient: failure to enter a treatment programme, premature termi­ nation of therapy and incomplete imple­ mentation of instructions, including pres­ criptions. Non-adherence to dry therapy may be categorized into four groups (Malahy, 1966): errors of omission, errrors of pur­ pose (taking medicine for wrong reasons), errors of dosage, and mistakes in timing or sequence. In psychiatric patients, ca­ pacity to cooperate may be impaired by the illness as well as by attitudes towards health and treatment. The commonest methods adopted to detect non-adherence are interrogation and tablets estimation by counting which, may be as misleading as interrogation. Other more reliable me­ thods that could be employed are the use of drug markers and drug detection in serum, C. S. F., urine etc.