Italian Translation and Validation of the Original ABC Taxonomy for Medication Adherence

Abstract

Medication adherence represents a complex and multifaceted process. Standardized terminology is essential to enable a reproducible process in various languages. The study’s aim was to translate and adapt the original Ascertaining Barriers for Compliance (ABC) Taxonomy on medication adherence, first proposed in 2012, into Italian language. The study was carried out according to the Preferred Methods for Translation of the ABC Taxonomy for Medication Adherence adopted by the ESPACOMP. Key steps included: (1) a systematic literature review using PubMed and Embase according to the PRISMA Guidelines to identify published Italian terms and definitions, and Italian adherence experts; (2) a forward translation of terms and definitions; (3) panelists’ selection; (4) a three-round Delphi survey. From the systematic review, 19 studies allowed detection of 4 terms, 4 definitions and 767 Italian experts. To these, Italian ESPACOMP members and experts though snowball sampling were added. The identified Italian adherence experts received the Delphi questionnaire. The Italian ABC Taxonomy was achieved after three rounds of Delphi survey by reaching at least a moderate consensus on unambiguous naming and definition of medication adherence-related terms. The Taxonomy is intended to be used in research, academic, and professional fields in order to harmonize adherence terminology and avoid confusion in comparing research findings.

Drug Utilization and Measurement of Medication Adherence: A Real World Study of Psoriasis in Italy

“…Medication adherence estimates were performed according the EMERGE guidelines on adherence developed under the umbrella of the European Ascertaining Barriers for Compliance (ABC) project. This taxonomy defines adherence as the process by which patients take their prescribed medications and comprises three essential components: (i) initiation; (ii) implementation; (iii) discontinuation [ 22 , 23 , 24 ]. The process starts with initiation when the patient takes the first dose of a prescribed medication.…”

“…The process continues with the implementation of the dosing regimen, defined as the extent to which a patient’s actual dosing corresponds to the prescribed dosing regimen, from initiation until the last dose is taken. Discontinuation marks the end of therapy, when the next dose to be taken is omitted and no more doses are taken thereafter [ 22 , 23 , 24 ]. We assessed the three phases of the adherence process as follows: (i) initiation was determined by the discrepancy between the drug prescribed in the treatment plans and the drug actually dispensed; (ii) the implementation phase was evaluated through the estimation of switching (i.e., a change in the prescription of the index drug to another drug of a different drug class) and swapping (i.e., a change in the prescription of the index drug to another drug within the same drug class) rates.…”