Patient Adherence and Treatment Outcome in Uncomplicated falciparum Malaria Treated with Supervised versus Non-Supervised Artesunate - Sulphadoxine - Pyrimethamine Regimen

Methods to Assess Adult and Adolescent Patients’ Adherence to Antimalarial Treatment: A Systematic Review

“…The same was observed for the quasi-experimental study, which is the only one that has comparative groups. Of the six clinical trials included in this review, five were deemed to be poor quality ( Fungladda et al, 1998 ; Qingjun et al, 1998 ; Asante et al, 2009 ; Saravu et al, 2018 ; Bagchi et al, 2020 ), and one fair quality ( Steury, 2016 ) according to the Cochrane Risk of Bias tool. None of the trials reported whether blinding was used either when assigning patients to treatment arms or when measuring endpoints.…”

“…Studies of P. falciparum treatment also reported a wide range of adherence rates: 45.4–92.6% by pill count ( Asante et al, 2009 ; Amponsah et al, 2015 ; Osorio-de-Castro et al, 2015 ), 66.7–100% by interview ( Rocha, 2008 ; Minzi et al, 2014 ; Osorio-de-Castro et al, 2015 ; Takahashi et al, 2018 ), 16.7% by electronic pillbox ( Steury, 2016 ), and 86.8–100% by biological assays ( Na-Bangchang et al, 1997 ; Minzi et al, 2014 ). The rate of adherence based on a combination of methods varied from 60 to 94.4% ( Takahashi et al, 2018 ; Oduro et al, 2019 ; Bagchi et al, 2020 ).…”

“…The indirect methods described were self-reports, pill counts, MEMS, and clinical cure. To measure adherence to antimalarial treatment, 76.2% (16/21) of the studies used a combination of methods, the most frequent of which were self-reported adherence and pill counts ( Fungladda et al, 1998 ; Lemma et al, 2011 ; Tun et al, 2012 ; Almeida et al, 2014 ; Ferreira et al, 2014 ; Osorio-de-Castro et al, 2015 ; Souza et al, 2016 ; Saravu et al, 2018 ; Takahashi et al, 2018 ; Oduro et al, 2019 ; Bagchi et al, 2020 ) ( Supplementary Table S2 and Table 1 ).…”

“…One study used the Morisky Medication Adherence Scale 8-item (MMAS-8) ( Morisky et al, 2008 ) questionnaire with dichotomous responses ( Rosa et al, 2020 ); however, study did not include a definition of adherence. Seven studies ( Fogg et al, 2004 ; Lemma et al, 2011 ; Tun et al, 2012 ; Minzi et al, 2014 ; Souza et al, 2016 ; Oduro et al, 2019 ; Bagchi et al, 2020 ) reported that the questionnaire applied included the time and date of the medication used by the patient ( Table 2 ).…”

“…More than half of the studies that utilized pill counts (12/18, 66.6%) classified the patient as adherent if there were no tablets remaining upon study completion ( Fungladda et al, 1998 ; Fogg et al, 2004 ; Lemma et al, 2011 ; Tun et al, 2012 ; Minzi et al, 2014 ; Amponsah et al, 2015 ; Osorio-de-Castro et al, 2015 ; Souza et al, 2016 ; Steury, 2016 ; Takahashi et al, 2018 ; Oduro et al, 2019 ; Bagchi et al, 2020 ). Four studies compared self-reports to pill counts as a validatory step.…”