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Evaluation of methods measuring medication adherence in patients with polypharmacy: a longitudinal and patient perspective

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Abstract

Purpose

To explore patients’ willingness to have medication adherence measured using different methods and evaluate the feasibility and validity of their combination (i.e., pill counts, a medication diary and a questionnaire assessing adherence two months post-discharge).

Methods

(1) A cross-sectional evaluation of the willingness of patients with polypharmacy to have their medication adherence measured post-discharge. (2) Medication adherence was monitored during two months using pill counts based on preserved medication packages and a diary in which patients registered their adherence-related problems. During a home visit, the Probabilistic Medication Adherence Scale (ProMAS) and a questionnaire on feasibility were administered.

Results

A total of 144 participants completed the questionnaire at discharge. The majority was willing to communicate truthfully about their adherence (97%) and to share adherence-related information with healthcare providers (99%). More participants were willing to preserve medication packages (76%) than to complete a medication diary (67%) during two months. Most participants reported that preserving medication packages (91%), completing the diary (99%) and the ProMAS (99%) were no effort to them. According to the majority of participants (60%), pill counts most accurately reflected medication adherence, followed by the diary (39%) and ProMAS (1%). Medication adherence measured by pill counts correlated significantly with ProMAS scores, but not with the number of diary-reported problems. However, adherence measured by the medication diary and ProMAS correlated significantly.

Conclusion

Combining tools for measuring adherence seems feasible and can provide insight into the accordance of patients’ actual medication use with their prescribed regimen, but also into problems contributing to non-adherence.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

L.M. was supported by the Research Foundation Flanders through grant 11L0522N. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Department of Nursing Science and Midwifery, Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    Laura Mortelmans, Eva Goossens, Marjan De Graef, Jana Van Dingenen & Tinne Dilles

  2. Research Foundation Flanders (FWO), Brussels, Belgium

    Laura Mortelmans

  3. Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium

    Eva Goossens

  4. Department of Patient Care, Antwerp University Hospital (UZA), Antwerp, Belgium

    Eva Goossens

  5. Department of Geriatrics, ZNA, Antwerp, Belgium

    Anne-Marie De Cock

  6. Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium

    Anne-Marie De Cock

  7. Department of Geriatrics, Ghent University Hospital, Ghent, Belgium

    Mirko Petrovic

  8. Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium

    Mirko Petrovic

  9. Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands

    Patricia van den Bemt

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  1. Laura Mortelmans
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  7. Patricia van den Bemt
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  8. Tinne Dilles
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Contributions

Conceptualization, L.M., E.G., M.D.G., J.V.D., AM.D.C. , M.P., P.v.d.B and T.D.; Methodology, L.M., E.G., M.D.G., J.V.D., AM.D.C. , M.P., P.v.d.B and T.D.; Funding acquisition: L.M.; Formal analysis; L.M., Writing—Original Draft, L.M., Writing—Review and Editing, L.M., E.G., M.D.G., J.V.D., AM.D.C. , M.P., P.v.d.B and T.D. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Laura Mortelmans.

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Mortelmans, L., Goossens, E., De Graef, M. et al. Evaluation of methods measuring medication adherence in patients with polypharmacy: a longitudinal and patient perspective. Eur J Clin Pharmacol 80, 891–900 (2024). https://doi.org/10.1007/s00228-024-03661-1

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