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Self-report measures of medication adherence behavior: recommendations on optimal use

  • Practice and Public Health Policies
  • Published:
Translational Behavioral Medicine

Abstract

Medication adherence plays an important role in optimizing the outcomes of many treatment and preventive regimens in chronic illness. Self-report is the most common method for assessing adherence behavior in research and clinical care, but there are questions about its validity and precision. The NIH Adherence Network assembled a panel of adherence research experts working across various chronic illnesses to review self-report medication adherence measures and research on their validity. Self-report medication adherence measures vary substantially in their question phrasing, recall periods, and response items. Self-reports tend to overestimate adherence behavior compared with other assessment methods and generally have high specificity but low sensitivity. Most evidence indicates that self-report adherence measures show moderate correspondence to other adherence measures and can significantly predict clinical outcomes. The quality of self-report adherence measures may be enhanced through efforts to use validated scales, assess the proper construct, improve estimation, facilitate recall, reduce social desirability bias, and employ technologic delivery. Self-report medication adherence measures can provide actionable information despite their limitations. They are preferred when speed, efficiency, and low-cost measures are required, as is often the case in clinical care.

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References

  1. Garfield S, Clifford S, Eliasson L, Barber N, Willson A. Suitability of measures of self-reported medication adherence for routine clinical use: a systematic review. BMC Medical Research Methodology. 2011; 11: 149.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Gonzalez JS, Schneider HE. Methodological issues in the assessment of diabetes treatment adherence. Current Diabetes Reports. 2011; 11: 472-479.

    Article  PubMed  Google Scholar 

  3. Hall KS, White KO, Reame N, Westhoff C. Studying the use of oral contraception: a review of measurement approaches. Journal of Women's Health. 2010; 19: 2203-2210.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Paschal AM, Hawley SR, St Romain T, Ablah E. Measures of adherence to epilepsy treatment: review of present practices and recommendations for future directions. Epilepsia. 2008; 49: 1115-1122.

    Article  PubMed  Google Scholar 

  5. Simoni JM, Kurth AE, Pearson CR, et al. Self-report measures of antiretroviral therapy adherence: A review with recommendations for HIV research and clinical management. AIDS and Behavior. 2006; 10: 227-245.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Velligan DI, Lam YW, Glahn DC, et al. Defining and assessing adherence to oral antipsychotics: a review of the literature. Schizophrenia Bulletin. 2006; 32: 724-742.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Nguyen TM, Caze AL, Cottrell N. (2013) What are validated self-report adherence scales really measuring?: a systematic review. British Journal of Clinical Pharmacology

  8. Garber MC, Nau DP, Erickson SR, Aikens JE, Lawrence JB. The concordance of self-report with other measures of medication adherence: a summary of the literature. Medical Care. 2004; 42: 649-652.

    Article  PubMed  Google Scholar 

  9. Wilson IB, Carter AE, Berg KM. Improving the self-report of HIV antiretroviral medication adherence: is the glass half full or half empty? Current HIV/AIDS Reports. 2009; 6: 177-186.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Osterberg L, Blaschke T. Adherence to medication. The New England Journal of Medicine. 2005; 353: 487-497.

    Article  CAS  PubMed  Google Scholar 

  11. Vrijens B, De Geest S, Hughes DA, et al. A new taxonomy for describing and defining adherence to medications. British Journal of Clinical Pharmacology. 2012; 73: 691-705.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Voils CI, Hoyle RH, Thorpe CT, Maciejewski ML, Yancy WS Jr. Improving the measurement of self-reported medication nonadherence. Journal of Clinical Epidemiology. 2011; 64: 250-254.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Cramer JA, Benedict A, Muszbek N, Keskinaslan A, Khan ZM. The significance of compliance and persistence in the treatment of diabetes, hypertension and dyslipidaemia: a review. International Journal of Clinical Practice. 2008; 62: 76-87.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. DiMatteo MR, Giordani PJ, Lepper HS, Croghan TW. Patient adherence and medical treatment outcomes: a meta-analysis. Medical Care. 2002; 40: 794-811.

    Article  PubMed  Google Scholar 

  15. Granger BB, Swedberg K, Ekman I, et al. Adherence to candesartan and placebo and outcomes in chronic heart failure in the CHARM programme: double-blind, randomised, controlled clinical trial. Lancet. 2005; 366: 2005-2011.

    Article  CAS  PubMed  Google Scholar 

  16. Rasmussen JN, Chong A, Alter DA. Relationship between adherence to evidence-based pharmacotherapy and long-term mortality after acute myocardial infarction. JAMA. 2007; 297: 177-186.

    Article  CAS  PubMed  Google Scholar 

  17. Simpson SH, Eurich DT, Majumdar SR, et al. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ. 2006; 333: 15.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Asche C, LaFleur J, Conner C. A review of diabetes treatment adherence and the association with clinical and economic outcomes. Clinical Therapeutics. 2011; 33: 74-109.

    Article  PubMed  Google Scholar 

  19. Hood KK, Peterson CM, Rohan JM, Drotar D. Association between adherence and glycemic control in pediatric type 1 diabetes: a meta-analysis. Pediatrics. 2009; 124: e1171-e1179.

    Article  PubMed  Google Scholar 

  20. Riegel B, Knafl GJ. Electronically monitored medication adherence predicts hospitalization in heart failure patients. Patient Prefer Adherence. 2013; 8: 1-13.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Dragomir A, Cote R, Roy L, et al. Impact of adherence to antihypertensive agents on clinical outcomes and hospitalization costs. Medical Care. 2010; 48: 418-425.

    Article  PubMed  Google Scholar 

  22. Pladevall M, Williams LK, Potts LA, et al. Clinical outcomes and adherence to medications measured by claims data in patients with diabetes. Diabetes Care. 2004; 27: 2800-2805.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Marin D, Bazeos A, Mahon FX, et al. Adherence is the critical factor for achieving molecular responses in patients with chronic myeloid leukemia who achieve complete cytogenetic responses on imatinib. Journal of Clinical Oncology. 2010; 28: 2381-2388.

    Article  CAS  PubMed  Google Scholar 

  24. Dragomir A, Cote R, White M, et al. Relationship between adherence level to statins, clinical issues and health-care costs in real-life clinical setting. Value in Health. 2010; 13: 87-94.

    Article  PubMed  Google Scholar 

  25. Briesacher BA, Andrade SE, Fouayzi H, Chan KA. Comparison of drug adherence rates among patients with seven different medical conditions. Pharmacotherapy. 2008; 28: 437-443.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004; 27: 1218-1224.

    Article  PubMed  Google Scholar 

  27. DiMatteo MR. Variations in patients' adherence to medical recommendations: a quantitative review of 50 years of research. Medical Care. 2004; 42: 200-209.

    Article  PubMed  Google Scholar 

  28. Vink NM, Klungel OH, Stolk RP, Denig P. Comparison of various measures for assessing medication refill adherence using prescription data. Pharmacoepidemiology and Drug Safety. 2009; 18: 159-165.

    Article  CAS  PubMed  Google Scholar 

  29. Yeaw J, Benner JS, Walt JG, Sian S, Smith DB. Comparing adherence and persistence across 6 chronic medication classes. Journal of Managed Care Pharmacy. 2009; 15: 728-740.

    PubMed  Google Scholar 

  30. de Klerk E, van der Heijde D, Landewe R, et al. Patient compliance in rheumatoid arthritis, polymyalgia rheumatica, and gout. Journal of Rheumatology. 2003; 30: 44-54.

    PubMed  Google Scholar 

  31. Mannheimer S, Thackeray L, Huppler Hullsiek K, et al. A randomized comparison of two instruments for measuring self-reported antiretroviral adherence. AIDS Care. 2008; 20: 161-169.

    Article  CAS  PubMed  Google Scholar 

  32. Berg KM, Arnsten JH. Practical and conceptual challenges in measuring antiretroviral adherence. Journal of Acquired Immune Deficiency Syndromes. 2006; 43(Suppl 1): S79-S87.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Chesney MA. The elusive gold standard. Future perspectives for HIV adherence assessment and intervention. Journal of Acquired Immune Deficiency Syndromes. 2006; 43(Suppl 1): S149-S155.

    Article  PubMed  Google Scholar 

  34. Quittner AL, Modi AC, Lemanek KL, Ievers-Landis CE, Rapoff MA. Evidence-based assessment of adherence to medical treatments in pediatric psychology. Journal of Pediatric Psychology. 2008; 33: 916-936. discussion 937–918.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Williams AB, Amico KR, Bova C, Womack JA. A proposal for quality standards for measuring medication adherence in research. AIDS and Behavior. 2013; 17: 284-297.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Kimmerling M, Wagner G, Ghosh-Dastidar B. Factors associated with accurate self-reported adherence to HIV antiretrovirals. International Journal of STD and AIDS. 2003; 14: 281-284.

    Article  PubMed  Google Scholar 

  37. Knobel H, Alonso J, Casado JL, et al. Validation of a simplified medication adherence questionnaire in a large cohort of HIV-infected patients: the GEEMA Study. AIDS. 2002; 16: 605-613.

    Article  PubMed  Google Scholar 

  38. Wagner G. Utility of self-reported antiretroviral adherence: Comment on Simoni et al. (2006). AIDS and Behavior. 2006; 10: 247-248.

    Article  PubMed  Google Scholar 

  39. Simoni JM, Montgomery A, Martin E, et al. Adherence to antiretroviral therapy for pediatric HIV infection: a qualitative systematic review with recommendations for research and clinical management. Pediatrics. 2007; 119: e1371-e1383.

    Article  PubMed  Google Scholar 

  40. Dobbels F, Berben L, De Geest S, et al. The psychometric properties and practicability of self-report instruments to identify medication nonadherence in adult transplant patients: a systematic review. Transplantation. 2010; 90: 205-219.

    Article  PubMed  Google Scholar 

  41. Bangsberg DR. Monitoring adherence to HIV antiretroviral therapy in routine clinical practice: the past, the present, and the future. AIDS and Behavior. 2006; 10: 249-251.

    Article  PubMed  Google Scholar 

  42. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. Journal of Clinical Hypertension. 2008; 10: 348-354.

    Article  PubMed Central  PubMed  Google Scholar 

  43. Chesney MA, Ickovics JR, Chambers DB, et al. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group (AACTG). AIDS Care. 2000; 12: 255-266.

    Article  CAS  PubMed  Google Scholar 

  44. Berg KM, Wilson IB, Li X, Arnsten JH. Comparison of antiretroviral adherence questions. AIDS and Behavior. 2012; 16: 461-468.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Greenlaw SM, Yentzer BA, O'Neill JL, Balkrishnan R, Feldman SR. Assessing adherence to dermatology treatments: a review of self-report and electronic measures. Skin Research and Technology. 2010; 16: 253-258.

    Article  PubMed  Google Scholar 

  46. Rand CS. "I Took the Medicine Like You Told Me, Doctor": Self-Report of Adherence with Medical Regimens. In: Stone AA, Turkkan JS, Bachrach CA, et al., eds. The science of self-report: Implications for research and practice. Mahwah, NJ: Lawrence Erlbaum Associates; 2000: 257-276.

    Google Scholar 

  47. Nieuwkerk PT, Oort FJ. Self-reported adherence to antiretroviral therapy for HIV-1 infection and virologic treatment response: a meta-analysis. Journal of Acquired Immune Deficiency Syndromes. 2005; 38: 445-448.

    Article  PubMed  Google Scholar 

  48. Kahana SY, Rohan J, Allison S, Frazier TW, Drotar D. A meta-analysis of adherence to antiretroviral therapy and virologic responses in HIV-infected children, adolescents, and young adults. AIDS and Behavior. 2013; 17: 41-60.

    Article  PubMed  Google Scholar 

  49. Usitalo A, Leister E, Tassiopoulos K, et al. Relationship between viral load and self-report measures of medication adherence among youth with perinatal HIV infection. AIDS Care. 2014; 26: 107-115.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Koschack J, Marx G, Schnakenberg J, Kochen MM, Himmel W. Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties. Journal of Clinical Epidemiology. 2010; 63: 299-306.

    Article  PubMed  Google Scholar 

  51. Dunbar-Jacob J, Sereika SM, Houze M, Luyster FS, Callan JA. Accuracy of measures of medication adherence in a cholesterol-lowering regimen. Western Journal of Nursing Research. 2012; 34: 578-597.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Voils CI, Maciejewski ML, Hoyle RH, et al. Initial validation of a self-report measure of the extent of and reasons for medication nonadherence. Medical Care. 2012; 50: 1013-1019.

    Article  PubMed Central  PubMed  Google Scholar 

  53. Gonzalez JS, Schneider HE, Wexler DJ, et al. Validity of medication adherence self-reports in adults with type 2 diabetes. Diabetes Care. 2013; 36: 831-837.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Arnsten JH, Demas PA, Farzadegan H, et al. Antiretroviral therapy adherence and viral suppression in HIV-infected drug users: comparison of self-report and electronic monitoring. Clinical Infectious Diseases. 2001; 33: 1417-1423.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  55. Shi L, Liu J, Koleva Y, et al. Concordance of adherence measurement using self-reported adherence questionnaires and medication monitoring devices. PharmacoEconomics. 2010; 28: 1097-1107.

    Article  PubMed  Google Scholar 

  56. Shi L, Liu J, Fonseca V, et al. Correlation between adherence rates measured by MEMS and self-reported questionnaires: a meta-analysis. Health and Quality of Life Outcomes. 2010; 8: 99.

    Article  PubMed Central  PubMed  Google Scholar 

  57. Bova CA, Fennie KP, Knafl GJ, et al. Use of electronic monitoring devices to measure antiretroviral adherence: practical considerations. AIDS and Behavior. 2005; 9: 103-110.

    Article  PubMed  Google Scholar 

  58. Pearson CR, Simoni JM, Hoff P, Kurth AE, Martin DP. Assessing antiretroviral adherence via electronic drug monitoring and self-report: an examination of key methodological issues. AIDS Behavior. 2006.

  59. Sajatovic M, Velligan DI, Weiden PJ, Valenstein MA, Ogedegbe G. Measurement of psychiatric treatment adherence. Journal of Psychosomatic Research. 2010; 69: 591-599.

    Article  PubMed Central  PubMed  Google Scholar 

  60. Steiner JF. Self-reported adherence measures: what do they assess and how should we use them? Medical Care. 2012; 50: 1011-1012.

    Article  PubMed  Google Scholar 

  61. Voils CI, Hoyle RH, Thorpe CT, Maciejewski ML, Yancy WS Jr. Response to Morisky & DiMatteo: Improving the measurement of self-reported medication nonadherence. Journal of Clinical Epidemiology. 2011; 64: 250-254.

    Article  PubMed Central  PubMed  Google Scholar 

  62. Kim MT, Hill MN, Bone LR, Levine DM. Development and testing of the Hill-Bone Compliance to High Blood Pressure Therapy Scale. Progress in Cardiovascular Nursing. 2000; 15: 90-96.

    Article  CAS  PubMed  Google Scholar 

  63. Krousel-Wood M, Islam T, Webber LS, et al. New medication adherence scale versus pharmacy fill rates in seniors with hypertension. The American Journal of Managed Care. 2009; 15: 59-66.

    PubMed Central  PubMed  Google Scholar 

  64. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care. 1986; 24: 67-74.

    Article  CAS  PubMed  Google Scholar 

  65. Shea S, Misra D, Ehrlich MH, Field L, Francis CK. Correlates of nonadherence to hypertension treatment in an inner-city minority population. American Journal of Public Health. 1992; 82: 1607-1612.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  66. Svarstad BL, Chewning BA, Sleath BL, Claesson C. The Brief Medication Questionnaire: a tool for screening patient adherence and barriers to adherence. Patient Education and Counseling. 1999; 37: 113-124.

    Article  CAS  PubMed  Google Scholar 

  67. Steiner JF. Rethinking adherence. Annals of Internal Medicine. 2012; 157: 580-585.

    Article  PubMed  Google Scholar 

  68. Feldman BJ, Fredericksen RJ, Crane PK, et al. Evaluation of the single-item self-rating adherence scale for use in routine clinical care of people living with HIV. AIDS and Behavior. 2013; 17: 307-318.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  69. Lu M, Safren SA, Skolnik PR, et al. Optimal recall period and response task for self-reported HIV medication adherence. AIDS and Behavior. 2008; 12: 86-94.

    Article  PubMed  Google Scholar 

  70. Wilson IB, Fowler FJ, Jr., Cosenza CA, et al. (2013) Cognitive and Field Testing of a New Set of Medication Adherence Self-Report Items for HIV Care. AIDS Behavior.

  71. Nieuwkerk PT, de Boer-van der Kolk IM, Prins JM, Locadia M, Sprangers MA. Self-reported adherence is more predictive of virological treatment response among patients with a lower tendency towards socially desirable responding. Antivir Ther. 2010; 15: 913-916.

    Article  CAS  PubMed  Google Scholar 

  72. Velligan DI, Weiden PJ, Sajatovic M, et al. Assessment of adherence problems in patients with serious and persistent mental illness: recommendations from the Expert Consensus Guidelines. Journal of Psychiatric Practice. 2010; 16: 34-45.

    Article  PubMed  Google Scholar 

  73. Tourangeau R, Smith TW. Asking sensitive questions: the impact of data collection mode, question format, and question context. Public Opinion Quarterly. 1996; 2: 275-304.

    Article  Google Scholar 

  74. Islam MM, Topp L, Conigrave KM, et al. The reliability of sensitive information provided by injecting drug users in a clinical setting: clinician-administered versus audio computer-assisted self-interviewing (ACASI). AIDS Care. 2012; 24: 1496-1503.

    Article  PubMed  Google Scholar 

  75. Newman JC, Des Jarlais DC, Turner CF, et al. The differential effects of face-to-face and computer interview modes. American Journal of Public Health. 2002; 92: 294-297.

    Article  PubMed Central  PubMed  Google Scholar 

  76. Des Jarlais DC, Paone D, Milliken J, et al. Audio-computer interviewing to measure risk behaviour for HIV among injecting drug users: a quasi-randomised trial. Lancet. 1999; 353: 1657-1661.

    Article  CAS  PubMed  Google Scholar 

  77. Kissinger P, Rice J, Farley T, et al. Application of computer-assisted interviews to sexual behavior research. American Journal of Epidemiology. 1999; 149: 950-954.

    Article  CAS  PubMed  Google Scholar 

  78. Locke SE, Kowaloff HB, Hoff RG, et al. Computer-based interview for screening blood donors for risk of HIV transmission. JAMA. 1992; 268: 1301-1305.

    Article  CAS  PubMed  Google Scholar 

  79. Sanders GD, Owens DK, Padian N, et al. A computer-based interview to identify HIV risk behaviors and to assess patient preferences for HIV-related health states. Proceedings of the Annual Symposium on Computer Applications in Medical Care. 1994:20–24.

  80. Wilson AS, Kitas GD, Carruthers DM, et al. Computerized information-gathering in specialist rheumatology clinics: an initial evaluation of an electronic version of the Short Form 36. Rheumatology (Oxford). 2002; 41: 268-273.

    Article  CAS  Google Scholar 

  81. Velikova G, Wright EP, Smith AB, et al. Automated collection of quality-of-life data: a comparison of paper and computer touch-screen questionnaires. Journal of Clinical Oncology. 1999; 17: 998-1007.

    CAS  PubMed  Google Scholar 

  82. Aiello EJ, Taplin S, Reid R, et al. In a randomized controlled trial, patients preferred electronic data collection of breast cancer risk-factor information in a mammography setting. Journal of Clinical Epidemiology. 2006; 59: 77-81.

    Article  PubMed  Google Scholar 

  83. Chinman M, Young AS, Schell T, Hassell J, Mintz J. Computer-assisted self-assessment in persons with severe mental illness. Journal of Clinical Psychiatry. 2004; 65: 1343-1351.

    Article  PubMed  Google Scholar 

  84. Perlis TE, Des Jarlais DC, Friedman SR, Arasteh K, Turner CF. Audio-computerized self-interviewing versus face-to-face interviewing for research data collection at drug abuse treatment programs. Addiction. 2004; 99: 885-896.

    Article  PubMed  Google Scholar 

  85. Kurth AE, Martin DP, Golden MR, et al. A comparison between audio computer-assisted self-interviews and clinician interviews for obtaining the sexual history. Sexually Transmitted Diseases. 2004; 31: 719-726.

    Article  PubMed  Google Scholar 

  86. Metzger DS, Koblin B, Turner C, et al. Randomized controlled trial of audio computer-assisted self-interviewing: utility and acceptability in longitudinal studies. HIVNET Vaccine Preparedness Study Protocol Team. American Journal of Epidemiology. 2000; 152: 99-106.

    Article  CAS  PubMed  Google Scholar 

  87. Ghanem KG, Hutton HE, Zenilman JM, Zimba R, Erbelding EJ. Audio computer assisted self interview and face to face interview modes in assessing response bias among STD clinic patients. Sexually Transmitted Infections. 2005; 81: 421-425.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  88. Hanscom B, Lurie JD, Homa K, Weinstein JN. Computerized questionnaires and the quality of survey data. Spine. 2002; 27: 1797-1801.

    Article  PubMed  Google Scholar 

  89. Bock B, Niaura R, Fontes A, Bock F. Acceptability of computer assessments among ethnically diverse, low-income smokers. American Journal of Health Promotion. 1999; 13: 299-304.

    Article  CAS  PubMed  Google Scholar 

  90. Castle T, Cunningham MA, Marsh GM. Antidepressant medication adherence via interactive voice response telephone calls. The American Journal of Managed Care. 2012; 18: e346-e355.

    PubMed  Google Scholar 

  91. Vollmer WM, Feldstein A, Smith DH, et al. Use of health information technology to improve medication adherence. The American Journal of Managed Care. 2011; 17: SP79-SP87.

    PubMed Central  PubMed  Google Scholar 

  92. Hettema JE, Hosseinbor S, Ingersoll KS. Feasibility and reliability of interactive voice response assessment of HIV medication adherence: research and clinical implications. HIV Clin Trials. 2012; 13: 271-277.

    Article  PubMed Central  PubMed  Google Scholar 

  93. Harris LT, Lehavot K, Huh D, et al. Two-way text messaging for health behavior change among human immunodeficiency virus-positive individuals. Telemed J E Health. 2010; 16: 1024-1029.

    Article  PubMed Central  PubMed  Google Scholar 

  94. Granholm E, Ben-Zeev D, Link PC, Bradshaw KR, Holden JL. Mobile assessment and treatment for schizophrenia (MATS): a pilot trial of an interactive text-messaging intervention for medication adherence, socialization, and auditory hallucinations. Schizophrenia Bulletin. 2012; 38: 414-425.

    Article  PubMed Central  PubMed  Google Scholar 

  95. Dowshen N, Kuhns LM, Johnson A, Holoyda BJ, Garofalo R. Improving adherence to antiretroviral therapy for youth living with HIV/AIDS: a pilot study using personalized, interactive, daily text message reminders. Journal of Medical Internet Research. 2012; 14: e51.

    Article  PubMed Central  PubMed  Google Scholar 

  96. Bender BG, Bartlett SJ, Rand CS, et al. Impact of interview mode on accuracy of child and parent report of adherence with asthma-controller medication. Pediatrics. 2007; 120: e471-e477.

    Article  PubMed  Google Scholar 

  97. Giordano TP, Guzman D, Clark R, Charlebois ED, Bangsberg DR. Measuring adherence to antiretroviral therapy in a diverse population using a visual analogue scale. HIV Clinical Trials. 2004; 5: 74-79.

    Article  PubMed  Google Scholar 

  98. Kalichman SC, Amaral CM, Swetzes C, et al. A simple single-item rating scale to measure medication adherence: further evidence for convergent validity. Journal of the International Association of Physicians in AIDS Care (Chicago, Ill). 2009; 8: 367-374.

    Article  Google Scholar 

  99. Walsh JC, Dalton M, Gazzard BG. Adherence to combination antiretroviral therapy assessed by anonymous patient self-report. AIDS. 1998; 12: 2361-2363.

    Article  CAS  PubMed  Google Scholar 

  100. Simoni J, Huh D, Wang Y, et al. The validity of self-reported medication adherence as an outcome in clinical trials of adherence-promotion interventions: findings from the MACH14 study. AIDS Behav. 2014; 18: 2285-2290.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Bangsberg DR, Hecht FM, Clague H, et al. Provider assessment of adherence to HIV antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes. 2001; 26: 435-442.

    Article  CAS  PubMed  Google Scholar 

  102. Byerly M, Fisher R, Whatley K, et al. A comparison of electronic monitoring vs. clinician rating of antipsychotic adherence in outpatients with schizophrenia. Psychiatry Research. 2005; 133: 129-133.

    Article  PubMed  Google Scholar 

  103. Miller LG, Liu H, Hays RD, et al. How well do clinicians estimate patients' adherence to combination antiretroviral therapy? Journal of General Internal Medicine. 2002; 17: 1-11.

    Article  PubMed Central  PubMed  Google Scholar 

  104. Ose D, Mahler C, Vogel I, et al. Let's talk about medication: concordance in rating medication adherence among multimorbid patients and their general practitioners. Patient Prefer Adherence. 2012; 6: 839-845.

    Article  PubMed Central  PubMed  Google Scholar 

  105. Velligan DI, Wang M, Diamond P, et al. Relationships among subjective and objective measures of adherence to oral antipsychotic medications. Psychiatric Services. 2007; 58: 1187-1192.

    Article  PubMed  Google Scholar 

  106. Thompson MA, Mugavero MJ, Amico KR, et al. Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel. Annals of Internal Medicine. 2012; 156: 817-833.

    Article  PubMed Central  PubMed  Google Scholar 

  107. Wolford G, Rosenberg SD, Rosenberg HJ, et al. A clinical trial comparing interviewer and computer-assisted assessment among clients with severe mental illness. Psychiatric Services. 2008; 59: 769-775.

    Article  PubMed  Google Scholar 

  108. Lofland JH, Schaffer M, Goldfarb N. Evaluating health-related quality of life: cost comparison of computerized touch-screen technology and traditional paper systems. Pharmacotherapy. 2000; 20: 1390-1395.

    Article  CAS  PubMed  Google Scholar 

  109. Williams CA, Templin T, Mosley-Williams AD. Usability of a computer-assisted interview system for the unaided self-entry of patient data in an urban rheumatology clinic. Journal of the American Medical Informatics Association. 2004; 11: 249-259.

    Article  PubMed Central  PubMed  Google Scholar 

  110. Smith MW, Sharit J, Czaja SJ. Aging, motor control, and the performance of computer mouse tasks. Human Factors. 1999; 41: 389-396.

    Article  CAS  PubMed  Google Scholar 

  111. Kim J, Trace D, Meyers K, Evens M. An empirical study of the Health Status Questionnaire System for use in patient-computer interaction. Proceedings AMIA Annual Fall Symptom. 1997:86–90.

  112. Feldman BJ, Fredericksen RJ, Crane PK, et al. Evaluation of the single-item self-rating adherence scale for use in routine clinical care of people living with HIV. AIDS Behavior. 2012.

  113. Erickson SR, Coombs JH, Kirking DM, Azimi AR. Compliance from self-reported versus pharmacy claims data with metered-dose inhalers. Annals of Pharmacotherapy. 2001; 35: 997-1003.

    Article  CAS  PubMed  Google Scholar 

  114. Duncan NA, Kronenberger WG, Roberson CP, Shapiro AD. VERITAS-PRN: a new measure of adherence to episodic treatment regimens in haemophilia. Haemophilia. 2010; 16: 47-53.

    Article  CAS  PubMed  Google Scholar 

  115. Reynolds NR, Sun J, Nagaraja HN, et al. Optimizing measurement of self-reported adherence with the ACTG Adherence Questionnaire: a cross-protocol analysis. Journal of Acquired Immune Deficiency Syndromes. 2007; 46: 402-409.

    Article  PubMed  Google Scholar 

  116. Munoz-Moreno JA, Fumaz CR, Ferrer MJ, et al. Assessing self-reported adherence to HIV therapy by questionnaire: the SERAD (Self-Reported Adherence) Study. AIDS Research and Human Retroviruses. 2007; 23: 1166-1175.

    Article  PubMed  Google Scholar 

  117. Godin G, Gagne C, Naccache H. Validation of a self-reported questionnaire assessing adherence to antiretroviral medication. AIDS Patient Care and STDs. 2003; 17: 325-332.

    Article  PubMed  Google Scholar 

  118. Amico KR, Fisher WA, Cornman DH, et al. Visual analog scale of ART adherence: association with 3-day self-report and adherence barriers. Journal of Acquired Immune Deficiency Syndromes. 2006; 42: 455-459.

    Article  PubMed  Google Scholar 

  119. Schroeder K, Fahey T, Hay AD, Montgomery A, Peters TJ. Adherence to antihypertensive medication assessed by self-report was associated with electronic monitoring compliance. Journal of Clinical Epidemiology. 2006; 59: 650-651.

    Article  PubMed  Google Scholar 

  120. Zeller A, Schroeder K, Peters TJ. An adherence self-report questionnaire facilitated the differentiation between nonadherence and nonresponse to antihypertensive treatment. Journal of Clinical Epidemiology. 2008; 61: 282-288.

    Article  PubMed  Google Scholar 

  121. Frazier PA, Davis-Ali SH, Dahl KE. Correlates of noncompliance among renal transplant recipients. Clinical Transplantation. 1994; 8: 550-557.

    CAS  PubMed  Google Scholar 

  122. Tucker CM, Petersen S, Herman KC, et al. Self-regulation predictors of medication adherence among ethnically different pediatric patients with renal transplants. Journal of Pediatric Psychology. 2001; 26: 455-464.

    Article  CAS  PubMed  Google Scholar 

  123. Chisholm MA, Lance CE, Williamson GM, Mulloy LL. Development and validation of the immunosuppressant therapy adherence instrument (ITAS). Patient Education and Counseling. 2005; 59: 13-20.

    Article  PubMed  Google Scholar 

  124. Cukor D, Rosenthal DS, Jindal RM, Brown CD, Kimmel PL. Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients. Kidney International. 2009; 75: 1223-1229.

    Article  PubMed  Google Scholar 

  125. Byerly MJ, Nakonezny PA, Rush AJ. The Brief Adherence Rating Scale (BARS) validated against electronic monitoring in assessing the antipsychotic medication adherence of outpatients with schizophrenia and schizoaffective disorder. Schizophrenia Research. 2008; 100: 60-69.

    Article  PubMed  Google Scholar 

  126. Scott J, Pope M. Self-reported adherence to treatment with mood stabilizers, plasma levels, and psychiatric hospitalization. The American Journal of Psychiatry. 2002; 159: 1927-1929.

    Article  PubMed  Google Scholar 

  127. Wicks P, Massagli M, Kulkarni A, Dastani H. Use of an online community to develop patient-reported outcome instruments: the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ). Journal of Medical Internet Research. 2011; 13, e12.

    Article  PubMed Central  PubMed  Google Scholar 

  128. Breuil V, Cortet B, Cotte FE, et al. Validation of the adherence evaluation of osteoporosis treatment (ADEOS) questionnaire for osteoporotic post-menopausal women. Osteoporosis International. 2012; 23: 445-455.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  129. de Klerk E, van der Heijde D, van der Tempel H, van der Linden S. Development of a questionnaire to investigate patient compliance with antirheumatic drug therapy. Journal of Rheumatology. 1999; 26: 2635-2641.

    PubMed  Google Scholar 

  130. McHorney CA, Victor Spain C, Alexander CM, Simmons J. Validity of the adherence estimator in the prediction of 9-month persistence with medications prescribed for chronic diseases: a prospective analysis of data from pharmacy claims. Clinical Therapeutics. 2009; 31: 2584-2607.

    Article  PubMed  Google Scholar 

  131. Kripalani S, Risser J, Gatti ME, Jacobson TA. Development and evaluation of the Adherence to Refills and Medications Scale (ARMS) among low-literacy patients with chronic disease. Value in Health. 2009; 12: 118-123.

    Article  PubMed  Google Scholar 

  132. DiMatteo MR, Sherbourne CD, Hays RD, et al. Physicians' characteristics influence patients' adherence to medical treatment: results from the Medical Outcomes Study. Health Psychology. 1993; 12: 93-102.

    Article  CAS  PubMed  Google Scholar 

  133. Wu JR, Chung M, Lennie TA, Hall LA, Moser DK. Testing the psychometric properties of the Medication Adherence Scale in patients with heart failure. Heart and Lung. 2008; 37: 334-343.

    Article  PubMed Central  PubMed  Google Scholar 

  134. Orwig D, Brandt N, Gruber-Baldini AL. Medication management assessment for older adults in the community. Gerontologist. 2006; 46: 661-668.

    Article  PubMed  Google Scholar 

  135. Zelikovsky N, Schast AP. Eliciting accurate reports of adherence in a clinical interview: development of the Medical Adherence Measure. Pediatric Nursing. 2008; 34: 141-146.

    PubMed  Google Scholar 

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Acknowledgments

The paper is based in part on an NIH Adherence Network meeting on “Advancing the Science of Adherence Assessment: A Working Meeting on Self-Report Measures,” sponsored by the NIH Office of Behavioral and Social Sciences (OBSSR) and held 17 October 2011. We are grateful to Shoshana Kahana for her contributions, to Janet de Moor, Martha Hare, Donna McCloskey, and Anne Trontell for their paper feedback, and to all members of the NIH Adherence Network for their support.

Source of funding

This paper was supported by the National Institutes of Health (NIH) Office of Behavioral and Social Sciences Research (OBSSR) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) through award number U01AR057954 (Crane). Additional support was provided through National Institute of Nursing Research (NINR) grant PO1NR010949 (Dunbar-Jacob), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant K12DK097696 (Hilliard), National Heart, Lung, and Blood Institute (NHLBI) grant K24HL111315 (Ogedegbe), and National Institute of Mental Health (NIMH) grants K24MH093243 (Simoni) and R01MH084759 (Crane). Further support (for Simoni and Crane) was provided by the University of Washington Center for AIDS Research (CFAR), an NIH-funded centers program (P30AI27757) which is collaboratively supported by NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, and NIA.

Authors’ statement of conflict of interest and adherence to ethical standards

The authors declare that they have no conflict of interest. All procedures were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Disclaimer

The views expressed in this article are those of the authors and should not be interpreted as the official recommendations or policy of the NIH, its constituent institutes, or other author-affiliated organizations.

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Authors and Affiliations

  1. NIH/National Institute of Mental Health Division of AIDS Research, Bethesda, MD, USA

    Michael J. Stirratt PhD

  2. School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA

    Jacqueline Dunbar-Jacob PhD

  3. Division of Infectious Diseases, University of Washington, Seattle, WA, USA

    Heidi M. Crane MD

  4. Department of Psychology, University of Washington, Seattle, WA, USA

    Jane M. Simoni PhD

  5. NIH/National Heart, Lung and Blood Institute, Bethesda, MD, USA

    Susan Czajkowski PhD

  6. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    Marisa E. Hilliard PhD

  7. Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA

    James E. Aikens PhD

  8. NIH/National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA

    Christine M. Hunter PhD

  9. Health Science Center, University of Texas, San Antonio, TX, USA

    Dawn I. Velligan PhD

  10. NIH/National Institute on Drug Abuse, Bethesda, MD, USA

    Kristen Huntley PhD

  11. School of Medicine, New York University, New York, NY, USA

    Gbenga Ogedegbe MD

  12. School of Medicine, Johns Hopkins University, Baltimore, MD, USA

    Cynthia S. Rand PhD

  13. NIH/National Eye Institute, Bethesda, MD, USA

    Eleanor Schron PhD

  14. National Science Foundation, Arlington, VA, USA

    Wendy J. Nilsen PhD

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  1. Michael J. Stirratt PhD
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  2. Jacqueline Dunbar-Jacob PhD
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  3. Heidi M. Crane MD
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Corresponding author

Correspondence to Michael J. Stirratt PhD.

Additional information

Implications

Practice: Routine assessment of medication adherence in clinical settings through brief, validated self-report measures can provide actionable information to medical providers about patient nonadherence.

Policy: Clinical guidelines should recommend routine assessment of medication adherence in clinical settings through validated self-report measures, and healthcare policies should support integration of this patient-reported outcome into electronic health records.

Research: The validity of self-report adherence measures may be enhanced through efforts to use validated scales, assess the proper construct, improve estimation, facilitate recall, reduce social desirability bias, and employ technologic delivery; further research to strengthen self-report adherence measures is needed.

Appendix

Appendix

Table 2 Selected Adherence Self-Report Measures in Chronic Disease Reporting Validity Data
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Stirratt, M.J., Dunbar-Jacob, J., Crane, H.M. et al. Self-report measures of medication adherence behavior: recommendations on optimal use. Behav. Med. Pract. Policy Res. 5, 470–482 (2015). https://doi.org/10.1007/s13142-015-0315-2

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