ISPOR International Panel Calls for Consensus on Medication Adherence Measures

Published Feb 26, 2024

Special Interest Group Identifies Significant Variations in Current Research Practices

Lawrenceville, NJ, USA—February 26, 2024—ISPOR—The Professional Society for Health Economics and Outcomes Research announced today the publication of a new report from the ISPOR Medication Adherence and Persistence Special Interest Group revealing significant inconsistencies in how researchers measure the effectiveness of interventions aimed at improving medication adherence. The report, “A Systematic Review of Outcomes for Assessment of Medication Adherence Enhancing Interventions: An ISPOR Special Interest Group Report” was published in the February 2024 issue of Value in Health.

"Medication nonadherence is prevalent across all disease areas, causing serious negative impact on clinical and economic outcomes," explained author Tamás Ágh, PhD, of the Syreon Research Institute in Budapest, Hungary. "Although several medication adherence-enhancing interventions have been developed in recent years, only a few of them have been implemented in routine healthcare practice. The lack of universal guidance on outcome measures for evaluating these interventions poses a challenge for assessing their effectiveness.”

The Special Interest Group’s literature review aimed to provide a systematic overview of outcome measures currently used for the value assessment of medication adherence-enhancing interventions. After analyzing 308 studies between January 2018 and September 2020, the majority of interventions found in the review were behavioral, with the most common methods being reminders and monitoring technologies. The most frequently assessed outcomes in included studies were medication adherence/persistence and clinical outcomes.

The authors note that measuring medication adherence is an ongoing challenge. There is no ”gold standard” for measuring adherence in research settings; each method has advantages and disadvantages. While self-reported adherence was the most utilized method in the reviewed studies, previous research has shown that self-report questionnaires, even validated ones, tend to overestimate medication adherence. Electronic medication monitoring was applied in only 17% of studies. To overcome the shortcomings of various adherence measures, the authors recommend combining multiple methods. The selection of specific approaches to be combined should be determined according to the clinical or research context. While combining multiple methods can improve the accuracy of measuring adherence, only 21% of studies have utilized this approach.

“Our findings highlight a lack of agreement on appropriate outcome measures for evaluating medication adherence-enhancing interventions and provide evidence that only a small number of studies explored economic and patient-reported outcomes," said Ágh. “To address these limitations, we recommend the development of consensus-based value criteria for assessing medication adherence-enhancing interventions. Such criteria could aid in standardizing evaluation methods and ultimately improve the effectiveness of these interventions.”

About ISPOR’s Medication Adherence and Persistence Special Interest Group

Medication nonadherence has a significant impact on patients’ morbidity and mortality. Behavioral interventions have been developed to improve medication adherence. Adherence research requires an understanding about the best methodology to conduct studies especially when assessing interventions. Adherence studies include various designs such as: randomized controlled clinical trials, observational, and quasi-experimental studies. The Medication Adherence and Persistence Special Interest Group will develop good research practice recommendations for the conduct of medication adherence and treatment persistence research studies and will provide insight on interventions that improve medication adherence.


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ISPOR—The Professional Society for Health Economics and Outcomes Research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.

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(ISSN 1098-3015) is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions. The journal’s 2022 impact factor score is 4.5 and its 5-year impact factor score is 6.2. Value in Health is ranked 8th of 87 journals in health policy and services, 21st of 105 journals in healthcare sciences and services, and 69th of 380 journals in economics. Value in Health is a monthly publication that circulates to more than 10,000 readers around the world.

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