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A Scoping Review of Methods Used to Assess Medication Adherence in Patients with Chronic Conditions

Konstantinou, P; Kasinopoulos, O; Karashiali, C; Georgiou, G; Panayides, A; Papageorgiou, A; Wozniak, G; ... Karekla, M; + view all (2021) A Scoping Review of Methods Used to Assess Medication Adherence in Patients with Chronic Conditions. Annals of Behavioral Medicine , Article kaab080. 10.1093/abm/kaab080. (In press). Green open access

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Abstract

BACKGROUND: Medication nonadherence of patients with chronic conditions is a complex phenomenon contributing to increased economic burden and decreased quality of life. Intervention development relies on accurately assessing adherence but no "gold standard" method currently exists. PURPOSE: The present scoping review aimed to: (a) review and describe current methods of assessing medication adherence (MA) in patients with chronic conditions with the highest nonadherence rates (asthma, cancer, diabetes, epilepsy, HIV/AIDS, hypertension), (b) outline and compare the evidence on the quality indicators between assessment methods (e.g., sensitivity), and (c) provide evidence-based recommendations. METHODS: PubMed, PsycINFO and Scopus databases were screened, resulting in 62,592 studies of which 71 met criteria and were included. RESULTS: Twenty-seven self-report and 10 nonself-report measures were identified. The Medication Adherence Report Scale (MARS-5) was found to be the most accurate self-report, whereas electronic monitoring devices such as Medication Event Monitoring System (MEMS) corresponded to the most accurate nonself-report. Higher MA rates were reported when assessed using self-reports compared to nonself-reports, except from pill counts. CONCLUSIONS: Professionals are advised to use a combination of self-report (like MARS-5) and nonself-report measures (like MEMS) as these were found to be the most accurate and reliable measures. This is the first review examining self and nonself-report methods for MA, across chronic conditions with the highest nonadherence rates and provides evidence-based recommendations. It highlights that MA assessment methods are understudied in certain conditions, like epilepsy. Before selecting a MA measure, professionals are advised to inspect its quality indicators. Feasibility of measures should be explored in future studies as there is presently a lack of evidence.

Type: Article
Title: A Scoping Review of Methods Used to Assess Medication Adherence in Patients with Chronic Conditions
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/abm/kaab080
Publisher version: https://doi.org/10.1093/abm/kaab080
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Assessment, Chronic conditions, Medication adherence, Scoping review, Self-reports
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research
URI: https://discovery.ucl.ac.uk/id/eprint/10136065
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