Assessing Medication Adherence Simultaneously by Electronic Monitoring and Pill Count in Patients With Mild-to-Moderate Hypertension

Medication adherence has been increasingly recognized as an important factor in elderly persons’ health. Various studies have shown that medication non-adherence is associated with poor health status in this population. As part of a study of the effects of two interventions to promote medication adherence in patients treated for memory problems, information on medication adherence and cognitive status was collected at 3-month intervals. Twenty-seven participants (16 men, 11 women, age 71-92 years) were assigned to control or treatment conditions and adherence was evaluated with an electronic monitoring device. Cognitive status was evaluated at 3- month intervals beginning in April of 2003 and continuing through September of 2006. We have previously reported on the effectiveness of these interventions to promote adherence. In this paper, we examine the relations of cognitive status and adherence over time using a partial least squares path model in order to evaluate the extent to which adherence to cholinesterase medications was related to cognitive status. Adherence predicted cognitive status at later time points while cognition did not, in general, predict adherence. Results thus suggest that interventions to ensure high levels of medication adherence may be important for maintaining cognitive function in affected elderly people.

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Self-reported Morisky 8 item medication adherence scale to statins concords with pill count method and correlates with serum lipid profile parameters and Serum HMGCoA Reductase levels

10.1101/19006148 ◽

2019 ◽

Author(s):

Abhinav Grover ◽

Mansi Oberoi ◽

Harmeet Rehan ◽

Lalit Gupta ◽

Madhur Yadav

Keyword(s):

Medication Adherence ◽

Lipid Profile ◽

Density Lipoprotein ◽

Correlation Coefficients ◽

Pill Count ◽

Self Report ◽

Adherence Score ◽

Count Method ◽

High Adherence ◽

Adherence Scale

ABSTRACTBackgroundIt is imperative that non-compliance to statins be identified and addressed to optimize the clinical benefit of statins. Patient self-reporting methods are convenient to apply in clinical practice but need to be validated.ObjectiveWe studied the concordance of a patient self-report method, MMAS (Morisky eight item medication adherence scale) with pill count method in measuring adherence to statins and their correlation with extended lipid profile parameters and serum HMGCoA-R (hydroxymethylglutaryl coenzyme A reductase) enzyme levels.MethodsMMAS and pill count method were used to measure the adherence to statins in patients on statins for any duration. Patients were subjected to estimation of extended lipid profile and serum HMGCoA-R levels at the end of 3 months follow-up.ResultsOut of a total of 200 patients included in the study, 117 patients had low adherence (score less than 6 on MMAS) whereas 65 and 18 patients had medium (score 6 to less than 8) and high adherence (score of 8) respectively. Majority of patients who had low adherence to statins by MMAS were nonadherent by pill count method yielding concordance of 96.5%. Medium or high adherence to statins by MMAS method had concordance of 89.1% with pill count method. The levels of total cholesterol, low density lipoprotein-cholesterol, apolipoprotein B and HMGCoA-R were significantly negatively correlated with compliance measured by pill count and MMAS with similar correlation coefficients. HMGCoA-R levels demonstrated a plateau phenomenon with levels being 9-10 ng/ml when compliance to statin therapy was greater than 60% by pill count and greater than 6 on Morisky scale.ConclusionIn conclusion, MMAS and pill count methods showed concordance in measuring adherence to statins. These methods need to be explored further for their interchangeability as surrogates for biomarker levels.

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When Multiple Objective Measures of Medication Adherence Indicate Incongruent Adherence Results: An Example with Pediatric Cancer

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17061956 ◽

2020 ◽

Vol 17 (6) ◽

pp. 1956 ◽

Cited By ~ 1

Author(s):

Caitlin J. Cain ◽

Andrea R. Meisman ◽

Kirstin Drucker ◽

Evrosina I. Isaac ◽

Tanvi Verma ◽

...

Keyword(s):

Medication Adherence ◽

Pediatric Cancer ◽

Electronic Monitoring ◽

Lymphoblastic Leukemia ◽

Healthcare Providers ◽

Dose Intensity ◽

Maintenance Phase ◽

Objective Measures ◽

Treatment Regimens ◽

Household Environment

Previous research suggests that children and adolescents with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) often have difficulty adhering to complex treatment regimens during the maintenance phase of therapy. Measurement of treatment adherence can be done via objective (e.g., electronic monitoring (EM), pharmacological assays) or subjective methods (patient, parent, or physician reports). This paper provides an illustration of recommended strategies for comparing discrepancies between two objective measures of medication adherence (e.g., behavioral adherence using electronic monitoring versus pharmacological adherence using 6-mercaptopurine (6MP) metabolite data) within a relatively large cohort of pediatric patients with ALL or LBL (N = 139) who had longitudinal data for both measures of medication adherence over a 15-month period. Additionally, individual- and family-level factors such as gender, socioeconomic status, household environment, and dose intensity will be examined to identify possible sources of discrepancies between adherence measures. This information will provide practical advice for physicians, healthcare providers, and psychologists in identifying nonadherence and the caveats therein so patients achieve the best possible health outcomes.

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T107. MEDICATION ADHERENCE USING ELECTRONIC MONITORING IN SEVERE PSYCHIATRIC ILLNESS: 4 AND 24 WEEKS AFTER DISCHARGE

Schizophrenia Bulletin ◽

10.1093/schbul/sbz019.387 ◽

2019 ◽

Vol 45 (Supplement_2) ◽

pp. S245-S245

Author(s):

Seung Hyun Kim ◽

Jungseo Lee ◽

Jung Jin Kim ◽

Yujin Lee

Keyword(s):

Medication Adherence ◽

Psychiatric Illness ◽

Electronic Monitoring

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SELF-REPORTED MORISKY EIGHT ITEM MEDICATION ADHERENCE SCALE FOR STATINS CONCORDS WITH PILL COUNT METHOD AND CORRELATES WITH SERUM LIPID PROFILE PARAMETERS AND SERUM HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE LEVELS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(17)35247-6 ◽

2017 ◽

Vol 69 (11) ◽

pp. 1858

Author(s):

Abhinav Grover ◽

Harmeet Rehan ◽

Madhur Yadav ◽

Lalit Gupta

Keyword(s):

Medication Adherence ◽

Lipid Profile ◽

Serum Lipid ◽

Coenzyme A ◽

Pill Count ◽

Serum Lipid Profile ◽

Hydroxymethylglutaryl Coenzyme A Reductase ◽

Count Method ◽

Adherence Scale ◽

Coenzyme A Reductase

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Patient adherence to rivaroxaban in deep vein thrombosis, a cohort study in Switzerland: quantitative results

International Journal of Clinical Pharmacy ◽

10.1007/s11096-019-00928-x ◽

2019 ◽

Vol 41 (6) ◽

pp. 1625-1633

Author(s):

Jennifer Dotta-Celio ◽

Adriano Alatri ◽

Isabella Locatelli ◽

Monique Salvi ◽

Olivier Bugnon ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Medication Adherence ◽

Electronic Monitoring ◽

Patient Adherence ◽

Survival Curve ◽

Vitamin K Antagonists ◽

University Hospital ◽

Fixed Dose ◽

Vein Thrombosis ◽

Deep Vein

AbstractBackground Direct oral anticoagulants (DOACs) have the advantage of being administered orally at a fixed dose without laboratory monitoring, in contrast to the frequent international normalized ratio measurements used to adjust for vitamin K antagonists dosing. Rivaroxaban, has a short half-life. The anticoagulation effect rapidly decreases if medication adherence is suboptimal. Objective The purpose of this quantitative study (called RIVA) is to longitudinally describe adherence to rivaroxaban (implementation and persistence) in patients with deep vein thrombosis (DVT). Setting The community pharmacy of the Center for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland in collaboration with the angiology division of the Lausanne University Hospital (CHUV). Methods This is an observational study. Patients received rivaroxaban for 3 or 6 months: 15 mg twice a day during the first 3 weeks and then 20 mg once a day until the end of the treatment. Adherence was measured using electronic monitoring. Implementation and adherence were modelled using a generalized estimating equation model. Persistence was represented using a Kaplan–Meier survival curve. Main outcome measure Medication adherence (implementation and persistence). Results Thirty-one consecutive patients were included (68% male, mean age: 47 years old). The collected adherence data consisted of 57 inter-visit phases, 2899 electronic monitoring openings and a median follow-up of 92 days (IQR: 87; 100). Implementation to rivaroxaban was initially high [96.3 (92.8; 98.1)] but decreased during the first 3 weeks, until it reached 89.3 (76.0; 95.6). After the switch from twice a day 15 mg to a once a day 20 mg regimen, implementation increased again and remained stable [95.4 (92.2; 97.3)] for 90 days. Four patients who experienced adverse events discontinued the treatment before the end of the study and were considered non-persistent (clinically appropriate discontinuation). Conclusion Adherence to rivaroxaban in deep vein trombosis is high in persistent patients. Discontinuation is related to rivaroxaban adverse effects/toxicity. Implementation should be reinforced during the twice a day-phase, and this first 3-week experience should help patients and healthcare professionals choose the best timing for the once a day phase.

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