Mr Smith, please pick up

A short telephone call may increase the likelihood of women getting their prescriptions filled � but not men. A friendly reminder for forgetful patients

By Marcello Palmieri

A patient walks into your office, tells you their symptoms; you listen, maybe run a few tests, make a diagnosis and sometimes write them a script. The patient leaves with the slip in hand and all's well, right? Well, not necessarily.

Getting patients down to their local pharmacy to fill their prescriptions is obviously an important and necessary step on the road to recovery. However, studies have shown that although the majority of prescriptions are filled, for some serious conditions, like cardiovascular disease (CVD) and hypertension, compliance is worryingly low.

With this as their starting point, researchers from G�teborg University in Sweden decided to see if calling patients a week after they visited their family doctor would have any effect on prescription-filling. They then compared the prescriptions doctors wrote with what was actually dispensed at the pharmacies. The results of their study were published in the February issue of Family Practice.

They found that out of the 399 patients � randomized to either receive a short standardized followup call or no call � 90% had their prescriptions filled. Twenty percent were for drugs to treat CVDs, of which only 66% were filled � compared to 88% for all other drugs.

They also found that women were generally more diligent at filling their prescriptions than men, regardless of whether they received a phone call or not, although the phone call did tend to increase their compliance. Men, on the other hand, showed no change in compliance even after the doctor called them back.

Dr Colin McMillan, a cardiologist from Charlottetown, wasn't surprised by the results � nor was he bowled over by them. "The number of patients is relatively small and the applicability to Canadian practice isn't assured," he said. That said, Dr McMillan does believe that it's a good idea for doctors to start making these followup calls.

SORRY DOC, I FORGOT
Another long-standing problem is that even when patients get their prescriptions filled and have them sitting in the kitchen cupboard, it doesn't mean that they'll take them � even if they suffer from an extremely serious condition. A recent study from the University of Michigan Cardiovascular Center presented at the Annual Scientific Session of the American College of Cardiology on March 10 investigated the reasons why some heart attack patients don't take four key drugs that can help them stay alive. The number one reason reported by the 154 patients in the study was that they had simply forgotten.

So maybe what these patients need is also a quick phone call to remind them to take their meds, not just fill the prescription. This is exactly what Dr David Green, a family doctor in Cape Town, South Africa, had in mind when he set up an information service called On-Cue Compliance (www.on-cue.co.za) in 2002 that sends patients text messages to their cell phones reminding them to take their medications.

Dr Green told the BBC that his service works because so many people have their cell phones on them at all times. The On-Cue Compliance service is now being used by patients in Australia, Belgium and the UK and will soon be making its way into North America.