New terminology of medication adherence enabling and supporting activities: ENABLE terminology

Przemyslaw Kardas; Emma Aarnio; Tamas Agh; Job F M van Boven; Alexandra Lelia Dima; Cristina Mihaela Ghiciuc; Fatjona Kamberi; Guenka Ivanova Petrova; Urska Nabergoj Makovec; Indrė Trečiokienė

doi:10.3389/fphar.2023.1254291

New terminology of medication adherence enabling and supporting activities: ENABLE terminology

Front Pharmacol. 2023 Oct 13:14:1254291. doi: 10.3389/fphar.2023.1254291. eCollection 2023.

Affiliations

¹ Department of Family Medicine, Medical University of Lodz, Lodz, Poland.
² School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
³ Syreon Research Institute, Budapest, Hungary.
⁴ Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
⁵ Health Technology Assessment in Primary Care and Mental Health (PRISMA), Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Spain.
⁶ Pharmacology, Clinical Pharmacology and Algeziology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, Iași, Romania.
⁷ Scientific Research Centre for Public Health, Faculty of Health, University of Vlore "Ismail Qemali", Vlore, Albania.
⁸ Medical University Sofia, Sofia, Bulgaria.
⁹ Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia.
¹⁰ Pharmacy and Pharmacology Center, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Abstract

Introduction: Medication non-adherence negatively affects the effectiveness of evidence-based therapies and sustainability of healthcare systems. Lack of agreed terminology of medication adherence enabling and supporting activities leads to underuse of the available tools. The ENABLE COST Action was aimed at proposing a new terminology for these activities in order to help both scientific research and its clinical application. Methods: Initial discussions within the ENABLE Working Groups allowed for the conceptualization of four interlinked terms related to adherence, i.e., "medication adherence technology", "medication adherence enhancing intervention", "best practice" and "reimbursement". The iterative process of internal discussion was structured around two dedicated international workshops. Moreover, extensive stakeholder consultations have been organised, including an interactive online survey used to assess the level of agreement with, and the clarity of relevant terms and definitions proposed. Results: Detailed analysis of the results of this process allowed for fine-tuning of the items, and finally, for proposing the final set of definitions. Across all the three phases of this process, the definitions were substantially modified to better reflect the concepts, simplify the language, and assure completeness and cohesiveness of terminology. Feedback obtained from the stakeholders helped this process and confirmed that the final terms and definitions were well received by the experts active in the field of medication adherence. Discussion: Covering the gap in the existing terminology, this work proposes a cohesive set of terms and definitions applicable to medication adherence enabling and supporting activities. Promoting evidence-based approach to this field, this terminology may help research, clinical practice and policy.

Keywords: drugs; health policy; interventions; medication adherence; non-adherence; taxonomy; technology; terminology.

Grants and funding

This paper is based upon work from COST Action CA19132 “ENABLE,” supported by the COST (European Cooperation in Science and Technology).