Methods for Measuring Multiple Medication Adherence: A Systematic Review–Report of the ISPOR Medication Adherence and Persistence Special Interest Group

Pednekar, Priti; Ágh, Tamás; Malmenäs, Maria; Raval, Amit D.; Bennett, Bryan; Borah, Bijan J.; Hutchins, David; Manias, Elizabeth; Williams, Allison; Hiligsmann, Mickaël; Turcu-Știolică, Adina; Zeber, John E.; Abrahamyan, Lusine; Bunz, Thomas J.; Peterson, Andrew M.

doi:10.1016/j.jval.2018.08.006

Cited by 92 publications

(97 citation statements)

References 173 publications

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“…After applying the initial inclusion criteria for the systematic reviews, the full texts of 20 systematic reviews were obtained. Four were excluded after fulltext review, leaving 16 systematic reviews for data extraction (Vreeman et al, 2008;Elliott and Marriott, 2009;Vandenbroeck et al, 2011;AlGhurair et al, 2012;Paquin et al, 2013;Remor, 2013;Nguyen et al, 2014;Snyder et al, 2014;Akeroyd et al, 2015;Peŕez-Escamilla et al, 2015;Huang et al, 2016;Katusiime et al, 2016;Forbes et al, 2018;Pednekar et al, 2019;Pareja-Martinez et al, 2020;Plevinsky et al, 2020). From these 16 systematic reviews, 187 different adherence measures were extracted and coded.…”

Section: Resultsmentioning

confidence: 99%

Practical Barriers to Medication Adherence: What Do Current Self- or Observer-Reported Instruments Assess?

Chan

Cooper

Lycett³

et al. 2020

Front. Pharmacol.

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Introduction: Practical adherence barriers (e.g., medication frequency) are generally more amenable to intervention than perceptual barriers (e.g., beliefs). Measures which assess adherence barriers exist, however these tend to measure a mix of factors. There is a need to identify what practical barriers are captured by current measures. Aim: To identify and synthesise the practical adherence barriers which are assessed by currently available self-or observer-report adherence measures. Methods: A search for systematic reviews of self-or observer-report report adherence measures was conducted. Three electronic databases (Embase, Ovid Medline, and PsycInfo) were searched using terms based on adherence, adherence barriers and measures. Systematic reviews reporting on adherence measures which included at least one self-or observer-report questionnaire or scale were included. Adherence measures were extracted and coded on whether they addressed perceptual or practical barriers, or both. Practical items were then analysed thematically. Results: Following screening of 272 initial abstracts, 20 full-text papers were reviewed. Four were excluded after full-text review, leaving 16 systematic reviews for data extraction. From these, 187 different adherence measures were extracted and coded, and 23 unique measures were identified as assessing practical barriers and included in the final analysis. Seven key themes were identified: formulation; instructions for use; issues with remembering; capability-knowledge and skills; financial; medication supply and social environment. Conclusion: Existing adherence measures capture a variety of practical barriers which can be grouped into seven categories. These findings may be used to inform the development of a measure of practical adherence barriers.

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Section: Resultsmentioning

confidence: 99%

Practical Barriers to Medication Adherence: What Do Current Self- or Observer-Reported Instruments Assess?

Chan

Cooper

Lycett³

et al. 2020

Front. Pharmacol.

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“…We assessed adherence to ART using the pill count data, captured from patients’ re-fill chart and used for the purpose of clinical monitoring, together with clinicians’ report of skipped doses. Pill count is a valid method used to measure adherence to ART and has been used by several studies in resource limited settings [ 47 , 48 ]. Upon examination of the frequencies and distribution of our data, we found that the data were skewed towards high adherence.…”

Section: Methodsmentioning

confidence: 99%

Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia

et al. 2020

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Background Major depression is believed to affect treatment adherence and overall quality of life (QoL) of people living with HIV/AIDS (PLWHA). Comorbid major depression contributes to a two-fold higher risk of mortality among PLWHA. Understanding the relationships of major depression, adherence to antiretroviral therapy (ART) and QoL is important to identify areas for intervention. The aim of this study is to examine relationship of major depressive disorder (MDD) and adherence to ART with QoL, and to investigate socio-demographic and clinical factors associated with MDD, adherence and QoL among PLWHA in Northwest Ethiopia. Method A cross-sectional study was conducted in the ART clinic of Felege-Hiwot referral hospital in Northwest Ethiopia from July to October 2019. Adult PLWHA were selected using a systematic random sampling technique. Data were collected using interview administered questionnaires and chart reviews. Mini International Neuropsychiatric Interview and WHOQOL-HIV-BREF-Eth instruments were used to measure MDD and QoL respectively. Adherence to ART was assessed using pill count data from patients’ adherence monitoring chart. Univariate and multivariate Poisson regressions were used to assess associations of socio-demographic and clinical factors with MDD and adherence to ART. A multivariate linear regression was used to examine the associations of both MDD and adherence with overall QoL. Result Of the total of 393 invited participants, 391 (99.5%) completed the interviews. MDD was negatively associated with overall QoL: participants with MDD had a lower QoL score of 0.17 points compared to those with no MDD. MDD was associated with reduced adherence to ART when functional disability was controlled (RR = 1.43; 95%CI = 1.05, 1.96; p = 0.025). However, there was no statistical association between adherence to ART and overall QoL. Functional disability was associated with both MDD (RR = 5.07; 95%CI = 3.27,7.86; p < 0.001) and overall QoL (β = 0.29; 95%CI = 0.21,0.36; p < 0.001). Conclusion The relationship between MDD and QoL indicates the need for feasible, acceptable and evidence-based mental health interventions to reduce depression and improve overall QoL of PLWHA. We recommend future studies investigate causal relationships of MDD, adherence to ART and QoL of PLWHA to better understand priority areas for intervention.

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“…Methods for measuring adherence to treatment based on self-reported information may have certain limitations due to recall bias, social desirability and faults in self-observation [44]. However, the Morisky-Green test has been validated and has high specificity, a high positive predictive value and is easy to perform [27]; therefore, it is widely used.…”

Section: Limitationsmentioning

confidence: 99%

Social support, social context and nonadherence to treatment in young senior patients with multimorbidity and polypharmacy followed-up in primary care. MULTIPAP Study

et al. 2020

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Objective To estimate the prevalence of nonadherence to treatment and its relationship with social support and social context in patients with multimorbidity and polypharmacy followed-up in primary care. Methods This was an observational, descriptive, cross-sectional, multicenter study with an analytical approach. A total of 593 patients between 65-74 years of age with multimorbidity (�3 diseases) and polypharmacy (�5 drugs) during the last three months and agreed to participate in the MULTIPAP Study. The main variable was adherence (Morisky-Green). The predictors were social support (structural support and functional support (DUFSS)); sociodemographic variables; indicators of urban objective vulnerability; health-related quality of life (EQ-5D-5L-VAS & QALY); and clinical variables. Descriptive, bivariate and multivariate analyses with logistic regression models and robust estimators were performed.

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Methods for Measuring Multiple Medication Adherence: A Systematic Review–Report of the ISPOR Medication Adherence and Persistence Special Interest Group

Cited by 92 publications

References 173 publications

Practical Barriers to Medication Adherence: What Do Current Self- or Observer-Reported Instruments Assess?

Practical Barriers to Medication Adherence: What Do Current Self- or Observer-Reported Instruments Assess?

Major depressive disorder and its association with adherence to antiretroviral therapy and quality of life: cross-sectional survey of people living with HIV/AIDS in Northwest Ethiopia

Social support, social context and nonadherence to treatment in young senior patients with multimorbidity and polypharmacy followed-up in primary care. MULTIPAP Study

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