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Practical and analytic issues in the electronic assessment of adherence
Paul Cook1, Sarah Schmiege, Margaret McClean
1University of Colorado, College of Nursing, 13120 E. 19th Ave., Campus Box C288-04, Aurora, CO 80045, USA. Paul.Cook@ucdenver.edu
Western Journal of Nursing Research
|November 22, 2011
Summary
Electronic dose monitoring systems, like Medication Event Monitoring Systems (MEMS), offer valid adherence data but require careful use. Researchers should employ strategies like run-in periods and combined measures for accurate medication adherence assessment.
Area of Science:
- Pharmacology and Pharmaceutics
- Health Services Research
- Behavioral Science
Background:
- Medication adherence is crucial for treatment efficacy.
- Electronic monitoring, specifically Medication Event Monitoring Systems (MEMS), is favored over self-reports for accuracy.
- MEMS, despite popularity, present challenges in data collection and interpretation.
Purpose of the Study:
- To review literature and analyze MEMS data to propose best practices for its use.
- To enhance the validity and reliability of electronic monitoring in medication adherence research.
- To address potential limitations and improve the accuracy of MEMS in capturing patient adherence.
Main Methods:
- Literature review on medication adherence measurement.
- Analysis of existing Medication Event Monitoring Systems (MEMS) data.
- Development of recommended strategies for MEMS implementation and data analysis.
Main Results:
- A 1- to 2-month run-in period is suggested to mitigate MEMS reactivity.
- Combining MEMS with other adherence measures is recommended for comprehensive assessment.
- Continuous measurement or defining cutoffs based on medication pharmacology and nonadherence consequences is advised.
- Aggregation of MEMS data (weekly/monthly) and multilevel modeling are proposed for analysis.
- MEMS screening may overlook some patients requiring adherence interventions.
- Strategies to improve data completeness and accuracy include patient training and adequate supplies.
Conclusions:
- Optimizing MEMS usage involves methodological adjustments to enhance data quality.
- Careful implementation and analysis of MEMS data are essential for valid medication adherence research.
- Researchers should consider MEMS limitations and employ complementary strategies for robust adherence assessment.
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