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

Pinelopi Konstantinou; Orestis Kasinopoulos; Christiana Karashiali; Geοrgios Georgiou; Andreas Panayides; Alexia Papageorgiou; Greta Wozniak; Angelos P Kassianos; Maria Karekla

doi:10.1093/abm/kaab080

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

Ann Behav Med. 2022 Nov 18;56(12):1201-1217. doi: 10.1093/abm/kaab080.

Authors

Affiliations

¹ Department of Psychology, University of Cyprus, Cyprus.
² Department of Social and Behavioral Sciences, European University Cyprus, Cyprus.
³ 3AE Health LTD, Nicosia, Cyprus.
⁴ Department of Computer Science, University of Cyprus, Cyprus.
⁵ Medical School, University of Nicosia, Cyprus.
⁶ Department of Applied Health Research, UCL, London, UK.

PMID: 34570875
DOI: 10.1093/abm/kaab080

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.

Keywords: Assessment; Chronic conditions; Medication adherence; Scoping review; Self-reports.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Chronic Disease
Epilepsy*
Humans
Medication Adherence
Quality of Life*
Self Report