Multiple Adherence Tool Evaluation Study (MATES).

Area of Science:

• Health Services Research
• Pharmacy Practice
• Patient Adherence

Background:

• Medication nonadherence poses significant human and economic costs, necessitating effective identification and resolution strategies.
• Existing adherence tools require further research to optimize their practical application in healthcare settings.

Purpose of the Study:

• To evaluate pharmacist and student pharmacist experiences with the Adherence Estimator (AE) and Drug Adherence Work-up (DRAW) tools.
• To identify medication nonadherence issues using the AE and DRAW tools in community pharmacies and outpatient clinics.

Main Methods:

• A practice-based study utilized a crossover design in 6 primary care clinics and 4 community pharmacies.
• Pharmacists or student pharmacists administered the AE and DRAW tools to patients, with data analyzed descriptively and administrator experiences analyzed thematically.
• Each tool was administered approximately 20 times per site.

Main Results:

• The AE identified medium/high risk of nonadherence in 50% of patients, with 19% at high risk.
• The DRAW tool revealed that 82% of patients reported at least one reason for nonadherence, and 58% reported multiple reasons.
• While beneficial for identifying nonadherence and promoting dialogue, both tools required additional time and effort, with concerns raised about health literacy, patient reluctance, AE scaling, and DRAW length.

Conclusions:

• The AE and DRAW tools effectively uncover reasons for medication nonadherence within brief patient encounters (5-10 minutes).
• Barriers to the seamless integration of these adherence tools into busy clinical workflows were identified.