We appreciate the publication by Pedneakar and colleagues,1 which underlines the wide range of methods used in measuring multiple medication adherence (MMA). However, we disagree with several notions and have some suggested improvements for future reviews.
First, we think that assessing the existing measures for their ability to measure “true” MMA is missing the point. An interpretivism or constructivism epistemology rejects the notion of “one truth”2 and is particularly useful here to understand human behaviors in a social context, which is exactly the nature of the construct “adherence.” Different measures or various ways to calculate one measure help to examine human behaviors in specific contexts. As the authors cited other sources in their publication, the choice of a specific MMA measure might hinge on why adherence is being evaluated. Although we agree that standardization to some extent is certainly helpful in reducing the complexity of understanding this phenomenon, measures with variations do not mean that they are not “true.”