Patients' Self-Reported Adherence to Cardiovascular Medication Using Electronic Monitors as Comparators

Zeller, Andreas; Ramseier, Erich; Teagtmeyer, Anne; Battegay, Edouard

doi:10.1291/hypres.31.2037

Cited by 82 publications

(86 citation statements)

References 39 publications

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“…Self-reported adherence as simply yes or no is well-known to underestimate prevalence of non-adherence. 15 Prescription fill rate may be more accurate than self-reported adherence, but it is time consuming to track, and information may not be accurate if the patients are not in an integrated health care system or fill prescriptions but do not take the dispensed medication. Pill count is also time-consuming and accurate in determining adherence only in 50%-70% of patients when compared with electronic pillbox 16,17 and 68% when compared with therapeutic drug monitoring.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Morisky Medication Adherence Scale with therapeutic drug monitoring in apparent treatment–resistant hypertension

Pandey

Raza

Velasco

et al. 2015

Journal of the American Society of Hypertension

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The Morisky Medication Adherence Scale (MMAS-8) is a questionnaire developed for screening of non-adherence in patients with several chronic conditions, including uncomplicated hypertension. However, its accuracy in predicting nonadherence in patients with apparent treatment-resistant hypertension (a-TRH) is not known. Accordingly, we performed a retrospective study in 47 patients with a-TRH who had completed the eight-item MMAS during the initial clinic visit. Non-adherence was defined as presence of undetected serum levels of at least one prescribed antihypertensive drug by therapeutic drug monitoring. We found that 26% of patients were considered to have low adherence score (<6), while the actual prevalence of non-adherence was 51% by therapeutic drug monitoring. Sensitivity of the MMAS-8 was 26% (95% confidence interval, 10.3%-48.4%) with specificity of 75% (95% confidence interval, 53.3%-90.2%). By multivariate analysis, the MMAS-8 score was not an independent predictor of non-adherence, while certain clinical parameters such as heart rate were found to be independent predictors of non-adherence. Our study suggested limited accuracy of the MMAS-8 in detecting medication non-adherence in a-TRH. J Am Soc Hypertens 2015;9(6):420-426.

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Section: Discussionmentioning

confidence: 99%

Comparison of Morisky Medication Adherence Scale with therapeutic drug monitoring in apparent treatment–resistant hypertension

Pandey

Raza

Velasco

et al. 2015

Journal of the American Society of Hypertension

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“…The other measure of self-reported adherence used was a visual analogue scale, which asks patients to put a line on a 10-cm scale indicating how much of the time they use all of their glaucoma medications exactly as directed (range is from 0 ¼ none of the time to 10 ¼ all of the time). [39][40][41][42][43] The visual analogue scale has strong validity and reliability. [39][40][41][42][43] Forty-three packets were returned for a response rate of 72%.…”

Section: Discussionmentioning

confidence: 99%

“…[39][40][41][42][43] The visual analogue scale has strong validity and reliability. [39][40][41][42][43] Forty-three packets were returned for a response rate of 72%. Table 1 presents the patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

Development of an instrument to measure glaucoma medication self-efficacy and outcome expectations

Sleath

Blalock

Robin

et al. 2009

Eye

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Purpose The purpose of this study was to develop and evaluate the psychometric properties of (a) a glaucoma medication selfefficacy scale and (b) a glaucoma outcome expectations scale.Patients and Methods Two instruments were developed: a glaucoma medication selfefficacy scale and a glaucoma outcome expectations scale. Packets containing (a) the instruments and patient demographic questions and (b) a letter explaining the study were distributed to 225 glaucoma patients from three ophthalmology practices between August and December 2007. The instrument was completed by 191 patients for a response rate of 85%. Principal components factor analysis with a varimax rotation and Cronbach's a reliability were used to analyse the data. To assess discriminant validity, we administered the scales and two self-reported measures of adherence in a separate sample of 43 glaucoma patients who were currently using at least one glaucoma medication.Results Our results yielded a 21-item self-efficacy in overcoming barriers that might interfere with the use of glaucoma medications scale, a 14-item self-efficacy in carrying out specific tasks required to use eye drops correctly scale, and a four-item glaucoma outcome expectations scale. Results of the Cronbach's a reliability indicated that the scales are internally consistent. The selfefficacy scales were both significantly associated with two patient self-reported measures of glaucoma medication adherence, which show discriminant validity.Conclusions Eye care providers and researchers can use these scales to identify patients with low self-efficacy in using their glaucoma medications and patients who do not believe that following their eye care providers' advice can help their vision.

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“…Electronic monitoring is generally regarded as one of, and arguably the best method, for measuring medication adherence (MA [26,29]). EMD cap openings are generally presumed to be reasonable, albeit imperfect, proxies for medication taking that, shy of direct observation, serve as a Bgold standard^for verifying when patients take medications [29][30][31]. It is noted, however, that despite the utility of this approach, there are limits (i.e., patients may not necessarily ingest the medication when they opened the vial), and patients can subvert the technology if so ORIGINAL RESEARCH motivated [32].…”

Section: Assessing Adherencementioning

confidence: 99%

Desirability and feasibility of wireless electronic monitoring of medications in clinical trials

Robiner

Flaherty

Fossum

et al. 2015

Behav. Med. Pract. Policy Res.

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Medication nonadherence is a vexing problem in health care necessitating patients and health professionals' efforts to prevent, minimize, or reverse it. Research participants' inconsistent medication taking obscures treatment efficacy and adds costs to biomedical research. Electronic monitoring devices (EMDs), like the Medication Event Monitoring System (MEMS), have grown in sophistication, providing precise, timely insights into individuals' medication-taking patterns across clinical populations. This article reports on the desirability and feasibility study of using a wireless EMD in clinical research to promote adherence to clinical regimens and research protocols. Nonadherence in transplant patients has been linked to late acute rejection and graft loss. High levels of adherence (97.7 %) were documented for six renal transplant recipients for a mean of 6 months (M=196.1±71.2 days) who indicated acceptance of the technology. MEMS data confirmed the feasibility of using wireless EMDs to monitor medication use. Monitoring provides greater assurance that research studies reflect the biological impact of medications and provide a basis for targeting adherence enhancement efforts within research investigations.

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Patients' Self-Reported Adherence to Cardiovascular Medication Using Electronic Monitors as Comparators

Abstract: The aim of this study was to evaluate self-reporting of adherence to cardiovascular medication using elec-

Cited by 82 publications

References 39 publications

Comparison of Morisky Medication Adherence Scale with therapeutic drug monitoring in apparent treatment–resistant hypertension

Comparison of Morisky Medication Adherence Scale with therapeutic drug monitoring in apparent treatment–resistant hypertension

Development of an instrument to measure glaucoma medication self-efficacy and outcome expectations

Desirability and feasibility of wireless electronic monitoring of medications in clinical trials

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