Medication Adherence Measures: An Overview

Abstract

WHO reported that adherence among patients with chronic diseases averages only 50% in developed countries. This is recognized as a significant public health issue, since medication nonadherence leads to poor health outcomes and increased healthcare costs. Improving medication adherence is, therefore, crucial and revealed on many studies, suggesting interventions can improve medication adherence. One significant aspect of the strategies to improve medication adherence is to understand its magnitude. However, there is a lack of general guidance for researchers and healthcare professionals to choose the appropriate tools that can explore the extent of medication adherence and the reasons behind this problem in order to orchestrate subsequent interventions. This paper reviews both subjective and objective medication adherence measures, including direct measures, those involving secondary database analysis, electronic medication packaging (EMP) devices, pill count, and clinician assessments and self-report. Subjective measures generally provide explanations for patient's nonadherence whereas objective measures contribute to a more precise record of patient's medication-taking behavior. While choosing a suitable approach, researchers and healthcare professionals should balance the reliability and practicality, especially cost effectiveness, for their purpose. Meanwhile, because a perfect measure does not exist, a multimeasure approach seems to be the best solution currently.

Stability of fetal hemoglobin levels in patients receiving metformin therapy

“…Of interest, patients on standard dose of metformin typically exhibit a plasma drug level of 70 µM. Although in this study, the blood levels of metformin were not obtained, so the drug adherence was not directly measured, the pharmacy-refill procedure could serve as a reliable and valid tool to assess adherence behavior in clinical settings 6 . In the present study, all patients presented with an excellent adherence to metformin therapy by means of pharmacy-refill method.…”

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“…A challenge in doing this, however, concerns the lack of consensus between researchers and clinicians on which tools are most appropriate to quantify the extent of adherence (Lam & Fresco, 2015). Currently, there exist several ways to assess adherence to inhaled medications.…”

“…This can provide real-time feedback and identify individual concerns (Lam & Fresco, 2015). Although simple and inexpensive to administer, self-report has been shown to be susceptible to considerable reporting biases.…”

“…Patients may under-report their level of non-adherence for a myriad of deliberate or accidental reasons (Lam & Fresco, 2015), including social desirability or recall biases.…”

Opioid risk assessment in palliative medicine

“…For that reason, pill or patch counts are most useful as an adjunct to other compliance methods, such as prescription monitoring programs and urine drug testing. 34 Written treatment agreement. An additional tool for opioid management is a written treatment agreement between the patient and the provider.…”