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Practical Barriers to Medication Adherence: What Do Current Self- or Observer-Reported Instruments Assess?

Amy Hai Yan Chan^1,2, Vanessa Cooper¹, Helen Lycett³

¹Centre of Behavioural Medicine, Department of Practice and Policy, University College London, London, United Kingdom.

Frontiers in Pharmacology

|June 2, 2020

Summary

This study identified seven categories of practical medication adherence barriers assessed by current measures. These findings can guide the development of new tools to better understand and address adherence challenges.

Keywords:

PRO (patient reported outcomes)adherence–compliance–persistence measurement medication patient report practical factors review (article)self-report measures

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Area of Science:

Pharmacology
Health Services Research
Patient Adherence

Background:

Practical adherence barriers, such as medication frequency, are more easily addressed than perceptual barriers like beliefs.
Existing adherence measures often combine various factors, necessitating a clearer understanding of practical barriers captured.
A need exists to identify specific practical barriers assessed by current adherence measurement tools.

Purpose of the Study:

To systematically identify and synthesize practical adherence barriers evaluated by existing self- or observer-report adherence measures.
To provide a clear overview of the practical aspects of medication adherence assessed in current literature.

Main Methods:

Conducted a systematic search for systematic reviews of self- or observer-report adherence measures across Embase, Ovid Medline, and PsycInfo.
Included systematic reviews that reported on adherence measures containing at least one self- or observer-report questionnaire or scale.
Extracted and coded adherence measures for perceptual or practical barriers, followed by thematic analysis of practical items.

Main Results:

Analyzed 16 systematic reviews, extracting and coding 187 adherence measures.
Identified 23 unique measures specifically assessing practical adherence barriers.
Thematic analysis revealed seven key categories of practical barriers: formulation, instructions for use, remembering, knowledge/skills, financial concerns, medication supply, and social environment.

Conclusions:

Current adherence measures encompass a range of practical barriers that can be systematically categorized.
The identified seven categories provide a framework for understanding practical adherence challenges.
These findings can inform the development of a dedicated measure for practical adherence barriers.