Adherence: Comparison of Methods to Assess Medication Adherence and Classify Nonadherence

Hansen, Richard A.; Kim, Mimi M.; Song, Liping; Tu, Wanzhu; Wu, Jingwei; Murray, Michael D.

doi:10.1345/aph.1l496

Cited by 252 publications

(228 citation statements)

References 27 publications

Supporting

Mentioning

219

Contrasting

Unclassified

Order By: Relevance

“…Patients may acquire the tablets but not take them and this measure does not provide us with information with respect to the time of taking the medication or reasons for non-adherence. However, it showed relatively good agreement with electronic pill container, especially in depressed patients (Hansen et al 2009). Moreover, this measure allowed us to collect information without the patient being aware that he or she was being assessed even when the patients did not keep their evaluation appointments.…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: A randomized controlled superiority trial

Rubio-Valera

March-Pujol

Fernández

et al. 2013

European Neuropsychopharmacology

View full text Add to dashboard Cite

Abstract:Major depression is associated with high burden, disability and costs. Non-adherence limits the effectiveness of antidepressants. Community pharmacists (CP) are in a privileged position to help patients cope with antidepressant treatment. The aim of the study was to evaluate the impact of a CP intervention on primary care patients who had initiated antidepressant treatment. Newly diagnosed primary care patients were randomised to usual care (UC) (92) or pharmacist intervention (87). Patients were followed up at 6 months and evaluated three times (Baseline, and at 3 and 6 months). Outcome measurements included clinical severity of depression (PHQ-9), health-related quality of life (HRQOL) (Euroqol-5D) and satisfaction with pharmacy care. Adherence was continuously registered from the computerised pharmacy records. Non-adherence was defined as refilling less than 80% of doses or having a medicationfree gap of more than 1 month. Patients in the intervention group were more likely to remain adherent at 3 and 6 month follow-up but the difference was not statistically significant.Patients in the intervention group showed greater statistically significant improvement in HRQOL compared with UC patients both in the main analysis and PP analyses. No statistically significant differences were observed in clinical symptoms or satisfaction with the pharmacy service. The results of our study indicate that a brief intervention in community pharmacies does not improve depressed patients' adherence or clinical symptoms. This intervention helped patients to improve their HRQOL, which is an overall measure of patient status.

show abstract

Section: Discussionmentioning

confidence: 93%

“…Non-adherence was defined as refilling <80% of the prescribed doses; a definition that has a reasonable balance between sensitivity and specificity (Hansen et al 2009) or having a treatment gap >1 month (Peterson et al 2007). …”

Section: Measurementsmentioning

confidence: 99%

Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: A randomized controlled superiority trial

Rubio-Valera

March-Pujol

Fernández

et al. 2013

European Neuropsychopharmacology

View full text Add to dashboard Cite

show abstract

“…First, this study was conducted at a single institution, and the results may not be generalizable. Second, although refill adherence is considered a valid and objective measure which correlates highly with pill count and electronic monitoring, 31,44,45 it is a surrogate outcome and does not directly capture daily medication taking behavior, which was a target of the illustrated medication schedule intervention. Third, refill adherence may be underestimated if patients use other pharmacies from which data are not available.…”

Section: Discussionmentioning

confidence: 99%

Improving Medication Adherence through Graphically Enhanced Interventions in Coronary Heart Disease (IMAGE-CHD): A Randomized Controlled Trial

2012

View full text Add to dashboard Cite

BACKGROUND: Up to 50 % of patients do not take medications as prescribed. Interventions to improve adherence are needed, with an understanding of which patients benefit most. OBJECTIVE: To test the effect of two low-literacy interventions on medication adherence. DESIGN: Randomized controlled trial, 2×2 factorial design. PARTICIPANTS: Adults with coronary heart disease in an inner-city primary care clinic. INTERVENTIONS: For 1 year, patients received usual care, refill reminder postcards, illustrated daily medication schedules, or both interventions. MAIN MEASURES: The primary outcome was cardiovascular medication refill adherence, assessed by the cumulative medication gap (CMG). Patients with CMG< 0.20 were considered adherent. We assessed the effect of the interventions overall and, post-hoc, in subgroups of interest. KEY RESULTS: Most of the 435 participants were elderly (mean age = 63.7 years), African-American (91 %), and read below the 9th-grade level (78 %). Among the 420 subjects (97 %) for whom CMG could be calculated, 138 (32.9 %) had CMG<0.20 during followup and were considered adherent. Overall, adherence did not differ significantly across treatments: 31.2 % in usual care, 28.3 % with mailed refill reminders, 34.2 % with illustrated medication schedules, and 36.9 % with both interventions. In post-hoc analyses, illustrated medication schedules led to significantly greater odds of adherence among patients who at baseline had more than eight medications (OR=2.2; 95 % CI, 1.21 to 4.04) or low self-efficacy for managing medications (OR=2.15; 95 % CI, 1.11 to 4.16); a trend was present among patients who reported non-adherence at baseline (OR= 1.89; 95 % CI, 0.99 to 3.60). CONCLUSIONS: The interventions did not improve adherence overall. Illustrated medication schedules may improve adherence among patients with low selfefficacy, polypharmacy, or baseline non-adherence, though this requires confirmation.KEY WORDS: coronary heart disease; medical adherence; medication management.

show abstract

“…Pharmacy refill records were used to measure IST adherence since they are an objective measure of the quantity of medication dispensed, are highly correlated with electronic medication monitoring, and have been used successfully in other medication adherence studies, demonstrating significant associations with health outcomes (34)(35)(36)(37). Additionally, research has indicated that RTRs who get their IST refills filled appropriately are more likely to have desired IST serum concentrations, indicating that RTRs took their IST (12).…”

Section: Outcome Measuresmentioning

confidence: 99%

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial

Chisholm-Burns

Spivey

Zivin

et al. 2013

American Journal of Transplantation

103

View full text Add to dashboard Cite

The objective of this randomized controlled trial was to assess the effects of a 1-year behavioral contract intervention on immunosuppressant therapy (IST) adherence and healthcare utilizations and costs among adult renal transplant recipients (RTRs). The sample included adult RTRs who were at least 1 year posttransplant, taking tacrolimus or cyclosporine and served by a specialty pharmacy. Pharmacy refill records were used to measure adherence and monthly questionnaires were used to measure healthcare utilizations. Direct medical costs were estimated using the 2009 Medicare Expenditure Panel Survey. Adherence was analyzed using the GLM procedure and the MIXED procedure of SAS. Rate ratios and 95% confidence intervals were estimated to quantify the rate of utilizing healthcare services relative to treatment assignment. One hundred fifty RTRs were enrolled in the study. Intervention group RTRs (n ¼ 76) had higher adherence than control group RTRs (n ¼ 74) over the study period (p < 0.01). And 76.1% of the intervention group compared with 42.7% of the control group was not hospitalized during the 1-year study period (RR ¼ 1.785; 95% CI: 1.314, 2.425), resulting in cost savings. Thus, evidence supports using behavioral contracts as an effective adherence intervention that may improve healthcare outcomes and lower costs.

show abstract

Adherence: Comparison of Methods to Assess Medication Adherence and Classify Nonadherence

Cited by 252 publications

References 27 publications

Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: A randomized controlled superiority trial

Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: A randomized controlled superiority trial

Improving Medication Adherence through Graphically Enhanced Interventions in Coronary Heart Disease (IMAGE-CHD): A Randomized Controlled Trial

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial

Contact Info

Product

Resources

About