How do patients use antimalarial drugs? A review of the evidence


Yeung, S; White, NJ; (2005) How do patients use antimalarial drugs? A review of the evidence. Tropical medicine & international health, 10 (2). pp. 121-138. ISSN 1360-2276 DOI: https://doi.org/10.1111/j.1365-3156.2004.01364.x

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Abstract

Patient adherence is a major determinant of the therapeutic response to antimalarial drugs, as most treatments are taken at home without medical supervision. With the introduction of new, effective, but more expensive antimalarials, there is concern that the high levels of efficacy observed in clinical trials may not be translated into effectiveness in the normal context of use. We reviewed available published evidence on adherence to antimalarial drugs and community drug usage; 24 studies were identified of which nine were 'intervention' studies, seven were classified as 'outcome studies', and the remainder were purely descriptive studies of antimalarial adherence. Definitions, methods, and results varied widely. Adherence was generally better when treatments were effective, and was improved by interventions focusing on provider knowledge and behaviour, packaging, and provision of correct dosages. There is insufficient information on this important subject, and current data certainly do not justify extrapolation from results with ineffective drugs to new effective treatments. Research in this area would benefit from of standardization of methodologies and the application of pharmacokinetic modelling.

Item Type: Article
Keywords: malaria, drug usage, adherence, developing countries, effectiveness, PLASMODIUM-FALCIPARUM MALARIA, SULFADOXINE-PYRIMETHAMINE, UNCOMPLICATED, MALARIA, CHILDHOOD MALARIA, HOME TREATMENT, ARTEMISININ DERIVATIVES, ARTESUNATE-MEFLOQUINE, HEALTH FACILITIES, BURKINA-FASO, CHILDREN, Antimalarials, administration & dosage, Community Health Services, Evidence-Based Medicine, Humans, Malaria, drug therapy, psychology, Patient Compliance, Self Administration, psychology, Treatment Outcome
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Malaria Centre
PubMed ID: 15679555
Web of Science ID: 227013400003
URI: http://researchonline.lshtm.ac.uk/id/eprint/6508

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