Sublingual nitroglycerin: improving patient compliance with a demonstration dose

Abstract

Forty-four patients were studied for compliance in the use of their first prescription for sublingual nitroglycerin. Fourteen HMO physicians participated in this randomized, prospective study by administering the first dose to half the patients during the office visit in which the diagnosis of angina pectoris was made. No other changes were made in the physicians' customary methods of diagnosing and treating angina pectoris. Patients who received the demonstration dose were significantly more likely to have used the sublingual nitroglycerin at least once before their second visit (75 percent of the study group compared with 44 percent of the control group). There was no difference between the groups in having the drug with them at the second visit. While serious reactions to sublingual nitroglycerin are rare, 6 patients experienced symptoms from the first dose, including 1 patient who fainted. The results suggest that compliance in using the initial prescription for sublingual nitroglycerin can be improved when the physician supervises the first dose.