The reliability of compliance assessments performed by doctors and patients during neuroleptic treatment: a comparison of compliance ratings

Objective: To compare compliance assessments made by doctors and patients during neuroleptic drug treatment and to detect any variables explaining the discrepancies between their ratings. Method: Compliance reports regarding neuroleptic medication were collected from 100 in-patients and out-patients and from their doctors. Re-ratings were performed after 1-2 weeks. Compliance ratings were compared with demographic, treatment and symptom-related variables and with the Attitudes to Neuroleptic Treatment (ANT) questionnaire using logistic regression analysis. Results: The doctors' and patients' compliance ratings showed good test-retest reliability (r=0.80, doctors; r=0.81, patients) and concordance (79% of the cases within the limits of +/- 25%-units deviation). Variables explaining discrepancies between the ratings included female gender, a low level of education, the diagnosis of mania, a high neuroleptic dose and several items from the ANT scale. Conclusion: Manic episodes, negative attitudes to neuroleptic medication and a high-dose treatment increase the risk for deviating views of compliance in the doctor-patient relationship.