TEOS: A framework for constructing operational definitions of medication adherence based on...

Area of Science:

• Health Services Research
• Methodology
• Pharmacology

Background:

• Medication adherence is critical for global health systems.
• Current adherence research faces methodological limitations, particularly in measurement accuracy and consistency.
• Existing guidelines (ABC, EMERGE) emphasize operational definitions but lack practical implementation guidance.

Purpose of the Study:

• To develop a structured approach for formulating operational definitions of medication adherence.
• To address the heterogeneity and low accuracy of adherence measures in research.
• To support researchers in making informed measurement decisions.

Main Methods:

• A consensus-based approach involving adherence and research methodology experts.
• Consideration of theoretical, methodological, and practical aspects of adherence measurement.
• Iterative refinement of a framework through expert review.

Main Results:

• Introduction of the TEOS framework, a four-component approach for operationalizing adherence.
• TEOS guides the description of treatment timelines, identification of key adherence events (ABC phases), alignment with study objectives, and selection of data sources.
• The framework facilitates the explicit reporting of measurement decisions.

Conclusions:

• The TEOS framework enhances the quality of medication adherence measurement.
• Explicitly using and reporting the TEOS components in research design and reporting improves adherence measurement quality.