Utilização de registros de dispensação de medicamentos na mensuração da adesão: revisão crítica da literatura

Abstract

The current frame of reference on adherence to pharmacotherapy includes a set of behaviors experienced by the user, with observation of the detailed and continuous history of the use of each dose of the medication. Indicators based on pharmacy records have been used to measure adherence. The current review aimed to identify and describe indicators based on pharmacy records and to discuss their adequacy and limitations for measuring adherence. An exploratory literature review was conducted in three databases using the terms "adherence", "pharmacy records/administrative data", and "measure" to compose the descriptors for the selection of 81 articles and the elaboration of a chart with the denomination, sources, methods for calculation, description, and interpretation of the operational and referential meaning of 14 indicators. Given the most recent taxonomy for adherence proposed in the literature, we concluded that the indicators can be useful for identifying patients with medication-seeking behavior-related problems and analysis of persistence. The distance between supply-related events and difficulties in treatment follow-up can influence an analysis based exclusively on the use of these indicators.

<p>Analysis of Adherence to Antihypertensive Drugs in Chinese Patients with Hypertension: A Retrospective Analysis Using the China Health Insurance Association Database </p>

“…Previously, treatment adherence was investigated using pill counts, clinical reports, prescriptions, and patient-reported information. 17 However, in recent years, new preferred approaches to measure treatment adherence have been developed, including patient-reported questionnaires, scales, medicine possession ratio (MPR), and proportion of days covered. 17 MPR, defined as the percentage/proportion of days’ supply obtained until the last refill (refill interval) or a specific time period (fixed refill), 18 , 19 is an established measure of AHT treatment adherence.…”

“… 17 However, in recent years, new preferred approaches to measure treatment adherence have been developed, including patient-reported questionnaires, scales, medicine possession ratio (MPR), and proportion of days covered. 17 MPR, defined as the percentage/proportion of days’ supply obtained until the last refill (refill interval) or a specific time period (fixed refill), 18 , 19 is an established measure of AHT treatment adherence. 20 – 22 It is generally <1; however, may exceed 1.0 if the patients obtain refills prior to their supply running out.…”

Adaptação transcultural do instrumento PAIR: Pharmacotherapy Assessment in Chronic Renal Disease para aplicação no Brasil

“…Além disso, essa avaliação estaria suscetível a vieses, considerando que a aderência ao tratamento é um comportamento pessoal, que envolve o uso do medicamento de acordo com as recomendações médicas 26 . Estimar aderência com base em dados de fornecimento significa pressupor que tudo que foi fornecido foi ingerido, em doses prescritas, nos horários e durante o tempo prescrito, ou seja, significa ignorar uma série de elementos intermediários que não foram investigados [26][27][28] .…”

Comparison of adherence measures using claims data in the South African private health sector

“…[2][3][4][5] There are several methods of computing adherence, and these include, inter alia, the use of biological assays and markers, directly observed therapy, self-reports, pill counts, use of surveys, questionnaires and electronic medication packaging. [2,4,[6][7][8][9][10][11] These methods, although beneficial, may be limited by cost, [6,10,11] ethical concerns [11] and self-reported bias. [6,7,10] Administrative claims data offer an inexpensive, efficient and noninvasive means by which adherence can be measured.…”