Abstract
WHO reported that adherence among patients with chronic diseases averages only 50% in developed countries. This is recognized as a significant public health issue, since medication nonadherence leads to poor health outcomes and increased healthcare costs. Improving medication adherence is, therefore, crucial and revealed on many studies, suggesting interventions can improve medication adherence. One significant aspect of the strategies to improve medication adherence is to understand its magnitude. However, there is a lack of general guidance for researchers and healthcare professionals to choose the appropriate tools that can explore the extent of medication adherence and the reasons behind this problem in order to orchestrate subsequent interventions. This paper reviews both subjective and objective medication adherence measures, including direct measures, those involving secondary database analysis, electronic medication packaging (EMP) devices, pill count, and clinician assessments and self-report. Subjective measures generally provide explanations for patient's nonadherence whereas objective measures contribute to a more precise record of patient's medication-taking behavior. While choosing a suitable approach, researchers and healthcare professionals should balance the reliability and practicality, especially cost effectiveness, for their purpose. Meanwhile, because a perfect measure does not exist, a multimeasure approach seems to be the best solution currently.
Highlights
Adherence to medication is a crucial part of patient care and indispensable for reaching clinical goals
Multimeasure approach is often recommended in measuring medication adherence
Since there is no ideal medication adherence measure, it is appropriate to use more than one measure when researchers intend to have results that are close to reality
Summary
Adherence to medication is a crucial part of patient care and indispensable for reaching clinical goals. The WHO defines adherence as “the extent to which the persons’ behavior (including medication-taking) corresponds with agreed recommendations from a healthcare provider” [1]. It includes the initiation of the treatment, implementation of the prescribed regime, and discontinuation of the pharmacotherapy [8]. With an understanding of whether the nonadherence is primary (initiation of pharmacotherapy) or secondary (implementation of the prescribed regime), and what factors have led to it, a proper intervention can be tailored individually to improve the medicationtaking behavior of each patient. The aim of this paper is to give an overview of validated and commonly used medication adherence measures and a general scope for identifying nonadherence in common situations
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