Effect of partial compliance on cardiovascular medication effectiveness

Physicians can picture themselves in the role of the ship's captain who sees ice in the water. Having learned about the high incidence of inadequate compliance and persistence, it is clear that every ice floe must be investigated to avoid potential disaster. We do not have the sonar system that helps the ship's captain scan under the water, but we can use other methods to avoid problems. We know that: taking three quarters of doses as prescribed leaves a wide window for potential cardiac disaster that is further increased when treatment is discontinued interruptions in the pharmacodynamic action of antihypertensive medications may compromise health in the short term or long term efficacy of some lipid lowering drugs is dose related. The collision course includes target organ damage over time. The American Heart Association has recommended use of strategies to enhance compliance to decrease morbidity and mortality from cardiovascular disease and stroke. The first task should be to help partial compliers develop better dosing habits to help to achieve this goal. Physicians who routinely discuss compliance and dose schedules, and who help patients select personalised cue reminders, can engage patients in their own care. Attention to compliance is a simple way to demonstrate special attention to patient care as well as improve medical success.