Assessing medication adherence with electronic monitoring

What is it about?

Electronic adherence monitoring devices (EAMD) are the gold standard of adherence measurement. Yet, no guidelines exist regarding the implementation and clinical usage of these devices. The authors outline a ten-step research methods framework including selecting an EAMD, creating standardized procedures, pre-testing equipment, educating staff, patients and providers, monitoring the medication regimen, transforming collected data, and computing adherence rates. No hard and fast rules are laid out. Instead, the authors offer thorough and detailed questions to prompt the researcher in identifying the methods that might work best for their particular needs at each of the ten steps. For instance, step three involves designing procedures for EAMD use and researchers are asked to consider the following for their particular needs: EAMD use timeline (e.g., passive use or run-in period), determine the procedures for downloading data (e.g., intermittent data downloads or at study completion, might be limited by participant burden or device features), and which features (e.g., alarms, text message reminders), if any, of the EAMD will be used.

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Photo by Myriam Zilles on Unsplash

Photo by Myriam Zilles on Unsplash

Why is it important?

As nonadherence results in potentially avoidable healthcare costs, treatment failure, and preventable deaths, improving medication adherence is a significant public health concern. While EAMD are considered the preferred method of measuring adherence, surprisingly, no guidelines exist for suing these devices. Improvements in adherence measurement, and EAMD, will hopefully, in turn, lead to improvements in adherence and related clinical outcomes.