The INCA^TM (Inhaler Compliance Assessment^TM): A comparison with established measures of adherence

A quantitative evaluation of adherence and inhalation technique among respiratory patients: An observational study using an electronic inhaler assessment device

“…This is due to the fact that the chosen EMD provides objective information on both the point in time (temporal adherence, which provides an indication about intentional non-adherence) and the user technique (technique adherence, which may be considered as unintentional non-adherence) each time the patient uses the inhaler. The same Irish study also revealed significant correlations between adherence rates measured via the EMD with adherence from dose counter 48 . 30 This discordance in results between the actual adherence as measured by the EMD and the other established adherence measures was similarly reported by studies conducted in Ireland using the same EMD.…”

“…30 This discordance in results between the actual adherence as measured by the EMD and the other established adherence measures was similarly reported by studies conducted in Ireland using the same EMD. 30,47,48 This in return calls into question the previously established adherence measures that are used in research (prescription refill, dose counter and self-reporting) and their applicability in real-life situations. Given the generated results, the use of the designated EMD would be useful in clinical practice particularly for respiratory patients who despite therapy optimisation, still show no improvement in their condition or still have their condition uncontrolled.…”

“…TA B L E 5 Actual adherence range by 20% bands and the frequency of patients within each band in reflecting the actual adherence behaviour of patients since these measures were significantly higher than the actual adherence rate as measured by the designated EMD. 30,47,48 This in return calls into question the previously established adherence measures that are used in research (prescription refill, dose counter A previous research in Ireland, which aimed to compare the same EMD against established adherence measures, highlighted the absence of associations between actual adherence with prescription refill (using PDC and medication possession ratio) and self-reported adherence, 48 but a small association between attempted adherence with prescription refill. 30,47 Hence, when both aspects are combined in the adherence calculations, a significantly lower actual adherence rate is calculated compared to established measures of adherence.…”

“…Afterwards, the AUC was calculated for the patient's 'actual adherence', which denotes attempted adherence at the correct intervals with no technique errors. 47,48…”

Medication adherence across the lifespan: Theory, methods, interventions and six grand challenges

“…The findings from Dima suggest that we can improve the way that we assess adherence in the context of asthma by refining how we use selfreport methodology in determining non-adherence to inhalers (Dima et al, 2017). Examining a specific medication taking behaviour, Moran and colleagues' (Moran et al, 2017) intriguing findings show a striking lack of convergent validity between a new electronic method of continuously monitoring the frequency and quality of inhaler adherence and a range of established methods of assessing inhaler adherence. This suggests that commonly used measures may capture a broad range of phenomena that appear to be empirically unrelated but are conceptually connected as indices of inhaler adherence.…”