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Related Experiment Videos

Methods for evaluation of medication adherence and persistence using automated databases.

Susan E Andrade1, Kristijan H Kahler, Feride Frech

  • 1Meyers Primary Care Institute, University of Massachusetts Medical School, Fallon Foundation, Fallon Community Health Plan, Worcester, MA 01605, USA. sandrade@meyersprimary.org

Pharmacoepidemiology and Drug Safety
|March 4, 2006
PubMed
Summary

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This systematic review found significant variation in methods for assessing medication adherence and persistence in pharmacoepidemiological studies. Standardizing these measures is crucial for reliable drug utilization research.

Area of Science:

  • Pharmacoepidemiology
  • Pharmacoeconomics
  • Health Services Research

Background:

  • Automated databases are increasingly used in pharmacoepidemiological and pharmacoeconomic research.
  • Assessing patient adherence and persistence is critical for understanding real-world medication use.
  • Standardized methods for evaluating adherence and persistence are lacking.

Purpose of the Study:

  • To systematically review current methods for assessing medication adherence and persistence.
  • To identify and categorize measures used in pharmacoepidemiological and pharmacoeconomic studies.
  • To highlight the diversity of approaches in the published literature.

Main Methods:

  • Systematic literature search of MEDLINE (1980-2004) for English-language studies.

Related Experiment Videos

  • Inclusion of studies evaluating adherence, compliance, persistence, switching, or discontinuations.
  • Use of automated dispensing data (pharmacy records) as the primary data source.
  • Independent review of abstracts and articles by two investigators.

    • Main Results:

    • 136 articles met the inclusion criteria.
    • Commonly reported measures include medication possession ratio (77 studies), discontinuation/continuation (58 studies), and switching (34 studies).
    • Other measures identified were medication gaps (13 studies), refill compliance (7 studies), and retentiveness/turbulence (4 studies).
    • Key considerations included assessment of drug exposure time and follow-up period specification.

    Conclusions:

    • Significant heterogeneity exists in terminology, definitions, and methods for assessing adherence and persistence.
    • The choice of measure should align with study objectives and consider the measure's advantages and limitations.
    • Further standardization may improve the comparability and reliability of pharmacoepidemiological research.