Published Dec 2019
Pednekar PP, Ágh T, Malmenäs M, et al. Methods for Measuring Multiple Medication Adherence: A Systematic Review–Report of the ISPOR Medication Adherence and Persistence Special Interest Group. Value in Health. 2019;22(2):139-156.
A broad literature base exists for measuring medication adherence to monotherapeutic regimens, but publications are less extensive for measuring adherence to multiple medications.
To identify and characterize the multiple medication adherence (MMA) methods used in the literature.
A literature search was conducted using PubMed, PsycINFO, the International Pharmaceutical Abstracts, the Cumulative Index to Nursing and Allied Health Literature and the Cochrane Library databases on methods used to measure MMA published between January 1973 and May 2015. A two-step screening process was used; all abstracts were screened by pairs of researchers independently, followed by a full-text review identifying the method for calculating MMA. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to conduct this systematic review. For studies that met the eligibility criteria, general study and adherence-specific characteristics and the number and type of MMA measurement methods were summarized.
The 147 studies that were included originated from 32 countries, in 13 disease states. Of these studies, 26 used proportion of days covered, 23 used medication possession ratio, and 72 used self-reported questionnaires (e.g., the Morisky Scale) to assess MMA. About 50% of the studies included more than one method for measuring MMA, and different variations of medication possession ratio and proportion of days covered were used for measuring MMA.
There appears to be no standardized method to measure MMA. With an increasing prevalence of polypharmacy, more efforts should be directed toward constructing robust measures suitable to evaluate adherence to complex regimens. Future research to understand the validity and reliability of MMA measures and their effects on objective clinical outcomes is also needed.
Full ContentLog In to View Report
- Medication Compliance and Persistence: Terminology and Definitions
- Initial Medication Adherence - Review and Recommendations for Good Practices in Outcomes Research: An ISPOR Medication Adherence and Persistence Special Interest Group Report
- Methods for Integrating Medication Compliance and Persistence in Pharmacoeconomic Evaluations
- Costs of Medication Non adherence in Patients with Diabetes Mellitus: A Systematic Review and Critical Analysis of the Literature
- Impact of Interventions on Medication Adherence and Blood Pressure Control in Patients with Essential Hypertension: A Systematic Review by the ISPOR Medication Adherence and Persistence Special Interest Group
- Systematic Literature Review of Psychosocial and Behavioral Factors Associated with Initial Medication Adherence
- Checklist for Medication Compliance and Persistence Studies Using Retrospective Databases
- Understanding Medication Compliance and Persistence from an Economics Perspective