<p>Assessing methods of measuring medication adherence in chronically ill children–a narrative review</p>

Abstract

Nonadherence in children who use long-term medication is a serious problem and assessing adherence is an important step to provide solutions to this problem. Medication adherence can be measured by several methods, including (a) self-report questionnaires or structured interviews, (b) therapeutic drug monitoring (TDM), (c) electronic devices, and (d) pick-up/refill rates. The objective of this narrative review is to provide an overview of the literature about methods for the measurement of medication adherence in chronically ill children and adolescents. Therefore, we conducted a literature search by using multiple databases. Four methods of monitoring medication adherence are presented for the most described chronic diseases: asthma, HIV/AIDS, epilepsy, diabetes mellitus and ADHD. First, 10 commonly used self-report questionnaires and structured interviews are described, including the main characteristics, (dis)advantages and their validation studies. Second, the use of TDM in pediatric trials for medication adherence measurement is discussed. New sampling methods (e.g. dried blood spot) and sampling matrices (e.g. hair, saliva and urine) have shown their benefits for TDM in children. Third, electronic devices to measure medication adherence in children are presented, being developed for several drug administration routes. Fourth, the analyses, advantages and disadvantages of pharmacy data are discussed. The usage of this data requires specific calculations and interpretations to assess adherence. As presented in this review, every adherence method has specific (dis)advantages. When deciding which adherence method is applicable, validity and generalizability should be taken into account. Combining multiple methods seems to offer the best solution in the daily clinical practice.

Real-world Evidence for Adherence and Persistence with Atorvastatin Therapy

“…These terms are used by medical professionals and other healthcare providers to give a comparative 'guide' to assess whether patients are taking their medication as prescribed. Although different methods for assessing adherence and persistence are still used in the medical literature [33][34][35][36] (see Electronic Supplementary Material [ESM] Table S1), taking medication in accordance with 100% of the prescribed regimen is rarely achieved in the realworld setting [30,37]. Consequently, patients will not receive the full therapeutic benefit from their medications, which in CVD means they remain at higher risk for major CV events than if they took their medications as prescribed [38].…”

Instruments Measuring Self-Care in Children and Young Adults With Chronic Conditions: A Systematic Review

“…Chronic diseases are defined broadly as conditions that last for a year or longer and require ongoing medical attention or limit activities of daily living or both ( 1 ). The prevalence of pediatric-onset chronic diseases is gradually increasing around the world ( 2 ), contributing to both morbidity and mortality ( 3 ). The number of children and young adults (CYAs), children aged 0–24 years ( 4 , 5 ), living with a chronic condition is growing due to higher survival rates ( 6 ).…”

Feasibility study of a health coaching intervention to improve contraceptive continuation in adolescent and young adult women in Philadelphia, Pennsylvania

“…Rather these findings point out that despite these best efforts, outcome data may not be available for at least 15% of patients—a fact that must be included when estimating sample sizes for a subsequent intervention trial. There are certainly other approaches to assessing medication adherence (e.g., therapeutic drug monitoring, electronic devices), 68 but none overcome the limitation of participant loss to health care follow up as well as our triangulated approach to continuation assessment.…”