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BMC Medical Research Methodology

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Open Access 01-12-2011 | Research article

Suitability of measures of self-reported medication adherence for routine clinical use: A systematic review

Authors: Sara Garfield, Sarah Clifford, Lina Eliasson, Nick Barber, Alan Willson

Published in: BMC Medical Research Methodology | Issue 1/2011

Abstract

Background

There is a recognised need to build primary care medication adherence services which are tailored to patients' needs. Continuous quality improvement of such services requires a regular working method of measuring adherence in order to monitor effectiveness. Self report has been considered the method of choice for clinical use; it is cheap, relatively unobtrusive and able to distinguish between intentional and unintentional non-adherence, which have different underlying causes and therefore require different interventions. A self report adherence measure used in routine clinical practice would ideally be brief, acceptable to patients, valid, reliable, have the ability to distinguish between different types of non-adherence and be able to be completed by or in conjunction with carers where necessary.

Methods

We systematically reviewed the literature in order to identify self report adherence measures currently available which are suitable for primary care and evaluate the extent to which they met the criteria described above. We searched the databases Medline, Embase, International Pharmaceutical Abstracts, Pharmline, CINAHL, PsycINFO and HaPI to identify studies reporting the development, validation or reliability of generic adherence measures. One reviewer screened all abstracts and assessed all relevant full text articles obtained and a second reviewer screened/assessed 10% to check reliability.

Results

Fifty eight measures were identified. While validation data were presented in support of the vast majority of self reported measures (54/58), data for a relatively small number of measures was presented for reliability (16/58) and time to complete (3/58). Few were designed to have the ability to be completed by or in conjunction with carers and few were able to distinguish between different types of non-adherence, which limited their ability be used effectively in the continuous improvement of targeted adherence enhancing interventions. The data available suggested that patients find it easier to estimate general adherence than to report a specific number of doses missed. Visual analogue scales can be easier for patients than other types of scale but are not suitable for telephone administration.

Conclusions

There is a need for a measure which can be used in the routine continual quality monitoring of adherence services.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2288/11/149/prepub

Title: Suitability of measures of self-reported medication adherence for routine clinical use: A systematic review
Authors: Sara Garfield
Sarah Clifford
Lina Eliasson
Nick Barber
Alan Willson
Publication date: 01-12-2011
Publisher: BioMed Central
Published in: BMC Medical Research Methodology / Issue 1/2011
Electronic ISSN: 1471-2288
DOI: https://doi.org/10.1186/1471-2288-11-149

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Suitability of measures of self-reported medication adherence for routine clinical use: A systematic review

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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