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A Scoping Review of Methods used to assess Medication Adherence in Patients with Chronic Conditions

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Authors: Pinelopi Konstantinou, Orestis Kasinopoulos, Christiana Karashiali, Geοrgios Georgiou, Andreas Panayides, Alexia Papageorgiou, Greta Wozniak, Angelos P. Kassianos & Maria Karekla


Background: Medication adherence (MA) of patients with chronic conditions is a complex phenomenon contributing to increased economic burden and decreased quality of life. Intervention development relies on accurately assessing MA but no “gold standard” method currently exists.

Purpose: The present scoping review aimed to: a) review and describe the current methods of assessing MA in patients with chronic conditions with the highest non-adherence rates (asthma, cancer, diabetes, epilepsy, HIV/AIDS, hypertension), b) outline the evidence on the quality of assessment methods, and c) examine the evidence on agreement between methods in assessing MA.

Methods: PubMed, PsycINFO and Scopus databases were screened, resulting in 62,592 studies of which 71 met criteria and were included.

Results: Twenty-seven self-report and ten non-self-report measures were identified. The Medication Adherence Report Scale (MARS-5) was found to be the most accurate self-report, whereas electronic monitoring devices such as Medication Event Monitoring System (MEMS) corresponded to the most accurate non-self-reports. Higher rates of MA were reported when assessed using self-reports compared to non-self-reports, except from pill counts.

Conclusions: This is the first review examining self and non-self-report assessment methods for medication adherence, across chronic conditions with the highest non-adherence rates and provides evidence-based recommendations. It highlights that MA assessment methods are understudied in certain conditions, such as epilepsy. Before selecting a MA measure, professionals are advised to inspect its quality indicators. Feasibility of self-report and non-self-report measures should be explored in future studies as there is presently a lack of evidence.

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