AIDS and Behavior

, Volume 17, Issue 1, pp 284–297 | Cite as

A Proposal for Quality Standards for Measuring Medication Adherence in Research

  • Ann Bartley WilliamsEmail author
  • K. Rivet Amico
  • Carol Bova
  • Julie A. Womack
Substantive Review


A decade after widespread recognition that adherence to medication regimens is key to antiretroviral effectiveness, considerable controversy remains regarding a “gold standard” for adherence measurement. Each adherence measurement approach has strengths and weaknesses and each rests on specific assumptions. The range of assumptions regarding adherence measurement and the diversity with which each approach is implemented strongly suggest that the evaluation of a particular measure outside of the context in which it was used (e.g. the study’s operational protocol) may result in undeserved confidence or lack of confidence in study results. The purpose of this paper is to propose a set of best practices across commonly used measurement methods. Recommendations regarding what information should be included in published reports regarding how adherence was measured are provided to promote improvement in the quality of measurement of medication adherence in research.


Adherence measurement Adherence self-report Electronic monitoring devices Pill-count Pharmacy refill 


Una década después del reconocimiento generalizado que la adherencia a los regímenes de medicación es fundamental para la efectividad del tratamiento antirretroviral (ARV), se mantiene una gran controversia con respecto al “patrón oro” para la calculación de adherencia. Cada método de calculación de adherencia tiene fortalezas y debilidades y cada uno se basa en suposiciones específicas. La variedad de suposiciones sobre la calculación de adherencia y la diversidad con la cual cada método es implementado, encarecidamente sugiere que la evaluación de un método en particular fuera del contexto del cual se utiliza (por ejemplo el protocolo operativo del estudio) puede resultar en confianza inmerecida o falta de confianza en los resultados del estudio. El propósito de este manuscrito es proponer una serie de las mejores prácticas de métodos de calculación comúnmente utilizados. Las recomendaciones respecto a la información que se debe incluir en los informes publicados acerca de cómo la adherencia fue calculada, son proporcionados para promover mejoría en la calidad de la calculación de adherencia al régimen de medicación en estudios de investigación.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ann Bartley Williams
    • 1
    • 5
    Email author
  • K. Rivet Amico
    • 2
  • Carol Bova
    • 3
  • Julie A. Womack
    • 4
  1. 1.School of NursingUniversity of California Los AngelesLos AngelesUSA
  2. 2.Center for Health, Intervention and PreventionUniversity of ConnecticutStorrsUSA
  3. 3.School of NursingUniversity of MassachusettsWorcesterUSA
  4. 4.School of NursingYale UniversityNew HavenUSA
  5. 5.UCLA School of Nursing Office of ResearchLos AngelesUSA

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