Adherence to Treatment – Reviewing Methods of Assessment and Improvement

Abstract

According to the World Health Organization (WHO), adherence is considered "the extent to which a person's behaviourtaking medication, following a diet, and/or executing lifestyle changes corresponds with agreed recommendations from a health care provider". Adherence rates average 50% in countries such as the United States, exerting important pressure on health systems. Factors which influence medication adherence can be related to the patient, the clinical conditions, therapy, socioeconomic factors and the healthcare system. Methods of adherence assessment are direct and indirect. While direct methods measure a certain drug or metabolite in body fluids of patients, indirect methods refer to self-report measures, pill count, electronic monitoring devices, electronic databases. The continuous growth of worldwide mobile phone use makes mHealth an important tool for both evaluating as well as improving adherence. RezumatConform Organizației Mondiale a Sănătății (OMS), aderența este măsura în care comportamentul unei persoane cu privire la administrarea medicamentelor, respectarea unei diete și/sau realizarea modificărilor stilului de viață, corespunde recomandărilor făcute de furnizorul de servicii de sănătate. Nivelurile de aderență sunt de 50% în țări precum Statele Unite, exercitând presiune importantă asupra sistemelor de sănătate. Factorii care influențează aderența la tratament pot fi legați de pacient, de condițiile clinice, de terapie, de factori socioeconomici și de sistemul de sănătate. Metodele de evaluare ale aderenței sunt directe și indirecte. În timp ce metodele directe măsoară un anumit medicament sau metabolit în lichidele biologice ale pacientului, metodele indirecte fac referire la cele de auto-raportare, la numărarea comprimatelor, la dispozitivele electronice de monitorizare precum și la bazele de date electronice. Creșterea continuă la nivel global a utilizării telefoanelor mobile face ca mHealth să fie o metodă importantă atât pentru evaluarea cât și îmbunătățirea aderenței.

Adherence determination using urine-tenofovir point-of-care testing and pharmacy refill records: A cross-sectional study

“…[21,22] Our findings are however at variance with some other previous studies which reported that pharmacy refill record was not a reliable method of adherence determination. [23] Of note, this finding is valid only for closed-pharmacy systems [24] where patients access medications from only one source, and the Nigerian National ARV programme is implemented as a closed-pharmacy system where patients can only pick-up ARVs from the pharmacy at the treatment center where they are registered.…”