Using Electronic Monitoring Devices to Assess Medication Adherence: a Research Methods Framework
- PDF / 1,056,710 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 59 Downloads / 187 Views
and Rachelle R. Ramsey, Ph.D1,2
1
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical CenterCincinnati, OH, USA; 2Department of Pediatrics, University of Cincinnati College of Medicine Cincinnati, OH, USA.
While electronic adherence monitoring devices (EAMDs) are the preferred and most objective medication adherence measurement strategy for many populations and research questions, there is no comprehensive methodological framework for EAMD use. We synthesize recommendations from experts in adherence science and the scientific literature to create a temporal framework of EAMD research methods. The goal of this framework is to provide a step-by-step guide that will enable researchers to design, prepare, implement, and clean data from rigorous, high-quality studies using EAMDs to assess adherence. Resources including a checklist of methodological considerations and example protocols have been created to assist readers in using this framework. KEY WORDS: medication adherence; research methods; electronic adherence monitoring device. J Gen Intern Med DOI: 10.1007/s11606-020-05905-z © Society of General Internal Medicine 2020
non-adherence, or medication taking behavior M edication that does not align with medical or health advice, is a 1
primary cause of treatment failure and a significant public health concern. 2 In the USA alone, medication nonadherence is estimated to result in over 100,000 preventable deaths and $100–$300 billion in potentially avoidable health care costs3, 4 each year. Increasing medication adherence, thus, has the potential to improve population health and reduce health care spending.5 Despite rapid growth in adherence science,6 effective methods of improving medication adherence remain largely unknown and there are few populations for which evidence-based adherencepromotion interventions are available.5, 7, 8 Efforts to improve adherence have been limited, in part, by the lack of accurate and reliable measures of medication-taking behavior.8 To date, medication adherence has primarily been assessed using self-report measures, a strategy known to overestimate adherence and Prior Presentations Springer This manuscript has not been presented previously. Received February 3, 2020 Accepted May 4, 2020
increase the study’s risk of bias.8 A more objective measure of medication adherence can be obtained via electronic adherence monitoring devices (EAMDs), electronic pill bottles, pill boxes, or inhaler attachments which contain a computer chip that records dates and times of device manipulations (e.g., inhaler actuations, bottle/box openings; hereafter referred to as actuations). As technological advances improve their affordability and accuracy,9, 10 EAMDs are increasingly being recognized as the preferred and most objective adherence measurement strategy for many populations and research questions.11 The features that make EAMDs attractive to researchers (e.g., collection of daily data) also pose numerous methodological questions (e.g., “How do I transf
Data Loading...
