Concordance of Adherence Measurement Using Self-Reported Adherence Questionnaires and Medication Monitoring Devices: An Updated Review
As medication adherence continues to be a prevalent issue in today’s society, the methods used to monitor medication-taking behaviors are constantly being re-evaluated and compared in search of the ‘gold standard’ measure. Our review aimed to assess the current literature surrounding the correlation between self-reported questionnaires (SRQs) and electronic monitoring devices to determine if these measures produce similar results.
We performed a literature search from 2009 to 2017 using PubMed, PubMed In-Process and Non-Indexed, EMBASE, Ovid MEDLINE, and Ovid MEDLINE In-Process. A keyword search using the terms ‘patient compliance’, ‘treatment compliance’, ‘medication adherence’, ‘drug monitoring’, ‘drug therapy’, ‘electronic’, ‘digital’, ‘computer’, ‘monitor’, ‘monitoring’, ‘drug’, ‘pharmaceutical preparations’, ‘compliance’, and ‘medications’ was done to capture all articles. We included articles measuring adherence using both monitoring devices and SRQs.
Thirty-five articles were included in this review. The average difference in measured adherence rates between the two measures was 9.2% (range −66.3 to 61.5). A majority (62.7%) of articles reported moderate (n = 12; 27.9%), high (n = 5, 11.6%), or significant (n = 10, 23.3%) correlations between SRQs and monitoring devices.
Results from our review are consistent with previous studies, as we found that many of our studies produced moderate to high correlation between both SRQs and monitoring devices [Farmer, Clin Ther 21(6):1074–90 (1999), IMS Institute for Healthcare Informatics. Avoidable costs in US health care (2012), Patel et al., Respirology 18(3):546–52 (2013), Siracusa et al., J Cyst Fibros 14(5):621–6 (2015), Smith et al., Int J Cardiol 145(1):122–3 (2010)]. Our findings demonstrate that self-reported adherence produces comparable results to electronic monitoring devices. As there is not yet a ‘gold standard’ measure for monitoring patient adherence, SRQs and Medication Event Monitoring Systems (MEMS) operating together continue to emerge as the preferred effective method for measuring medication adherence.
Data Availability Statement
All data that support these findings can be found in each of the articles listed in Table 3. Additionally, for further information, each article included in this review is listed in the References section.
The editor of PharmacoEconomics suggested the review. Alisha Monnette conducted the literature review, participated in the design, interpretation of the results, and led the writing of the manuscript. Yichen Zhang assisted the principal investigator with the literature search, performed the statistical analyses, and the interpretation of the results. Hui Shao participated in the analytical plan and interpretation of the results. Lizheng Shi was the consultant for the project and participated in the interpretation of the results and manuscript presentation. All authors contributed to the development of the manuscript and agreed on the final submitted version. The authors thank the editor and two anonymous reviewers for their constructive comments.
Compliance with Ethical Standards
No external funding was received.
Conflict of interest
No conflict exists for Alisha Monnette, Yichen Zhang, Hui Shao, or Lizheng Shi.
For this type of study formal consent is not required.
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