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Challenges in measuring medication adherence: experiences from a controlled trial

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Abstract

Measurement of adherence is complex and many methods, both direct and indirect are used; there is no universal gold standard. In this article, we share our experiences in a randomised controlled study, the Hypertension Adherence Program in Pharmacy trial, evaluating a community pharmacy-based intervention for improving adherence to antihypertensive medication. Several objective and subjective measures of adherence (Morisky score, TABS score, MedsIndex, Medicines Possession Ratio) were used, but produced varying results, limiting confidence in the conclusions that could be drawn. Despite using a specifically designed data mining software program to identify potentially nonadherent patients from dispensing records, many participants were found to be adherent by the self reported Morisky scale. A lesson to be learned when targeting people for interventions to improve adherence is that information from dispensing records should be supplemented by other methods in order to identify patients most in need of assistance.

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Acknowledgments

We acknowledge the other researchers on the HAPPy trial: Michael J. Bailey, Rosalind Lau, Jenny McDowell (Monash University), Diana Bortoletto (Monash University; Barwon Health); Shane L. Jackson, Gregory M. Peterson, Luke Bereznicki, Peter Gee (University of Tasmania); Jeffery D. Hughes (Curtin University); Ya-Seng (Arthur) Hsueh (The University of Melbourne).

Funding

The HAPPy Trial was funded by the Australian Government Department of Health and Ageing through the Fourth Community Pharmacy Agreement Research & Development Grants Program managed by The Pharmacy Guild of Australia.

Conflicts of interest

The authors declare no conflict of interests.

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Authors and Affiliations

  1. Centre for Medicine Use and Safety, Monash University (Parkville Campus), 381 Royal Parade, Parkville, VIC, 3052, Australia

    Kay Stewart, Kevin P. Mc Namara & Johnson George

  2. Greater Green Triangle University Department of Rural Health, Flinders University, Adelaide, SA, Australia

    Kevin P. Mc Namara

  3. Greater Green Triangle University Department of Rural Health, Deakin University, Warrnambool, VIC, Australia

    Kevin P. Mc Namara

Authors
  1. Kay Stewart
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  2. Kevin P. Mc Namara
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  3. Johnson George
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Corresponding author

Correspondence to Kay Stewart.

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Disclaimer The authors retain sole responsibility for the contents of this publication, which do not necessarily reflect the official views of the Australian Government Department of Health and Ageing or The Pharmacy Guild of Australia.

All authors have contributed significantly to the manuscript.

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Stewart, K., Mc Namara, K.P. & George, J. Challenges in measuring medication adherence: experiences from a controlled trial. Int J Clin Pharm 36, 15–19 (2014). https://doi.org/10.1007/s11096-013-9877-6

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