Abstract
Nonadherence to medication regimens is a worldwide challenge; adherence rates range from 38 to 57 % in older populations with an average rate of less than 45 % and nonadherence contributes to adverse drug events, increased emergency visits and hospitalisations. Accurate measurement of medication adherence is important in terms of both research and clinical practice. However, the identification of an objective approach to measure nonadherence is still an ongoing challenge. The aim of this Position Paper is to describe the advantages and disadvantages of the known medication adherence tools (self-report, pill count, medication event monitoring system (MEMS) and electronic monitoring devices, therapeutic drug monitoring, pharmacy records based on pharmacy refill and pharmacy claims databases) to provide the appropriate criteria to assess medication adherence in older persons. To the best of our knowledge, no gold standard has been identified in adherence measurement and no single method is sufficiently reliable and accurate. A combination of methods appears to be the most suitable. Secondly, adherence assessment should always consider tools enabling polypharmacy adherence assessment. Moreover, it is increasingly evident that adherence, as a process, has to be assessed over time and not just at one evaluation time point (drug discontinuation). When cognitive deficits or functional impairments may impair reliability of adherence assessment, a comprehensive geriatric assessment should be performed and the caregiver involved. Finally, studies considering the possible implementation in clinical practice of adherence assessment tools validated in research are needed.
| Original language | English |
|---|---|
| Pages (from-to) | 371-381 |
| Number of pages | 11 |
| Journal | Aging clinical and experimental research |
| Volume | 28 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jun 1 2016 |
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Keywords
- Adherence
- Chronic diseases
- Elderly
- Nonadherence
- Polypharmacy
- Tools
ASJC Scopus subject areas
- Ageing
- Geriatrics and Gerontology
Cite this
Toward appropriate criteria in medication adherence assessment in older persons : Position Paper. / Giardini, Anna; Martin, Maria Teresa; Cahir, Caitriona; Lehane, Elaine; Menditto, Enrica; Strano, Maria; Pecorelli, Sergio; Monaco, Alessandro; Marengoni, Alessandra.
In: Aging clinical and experimental research, Vol. 28, No. 3, 01.06.2016, p. 371-381.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Toward appropriate criteria in medication adherence assessment in older persons
T2 - Position Paper
AU - Giardini, Anna
AU - Martin, Maria Teresa
AU - Cahir, Caitriona
AU - Lehane, Elaine
AU - Menditto, Enrica
AU - Strano, Maria
AU - Pecorelli, Sergio
AU - Monaco, Alessandro
AU - Marengoni, Alessandra
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Nonadherence to medication regimens is a worldwide challenge; adherence rates range from 38 to 57 % in older populations with an average rate of less than 45 % and nonadherence contributes to adverse drug events, increased emergency visits and hospitalisations. Accurate measurement of medication adherence is important in terms of both research and clinical practice. However, the identification of an objective approach to measure nonadherence is still an ongoing challenge. The aim of this Position Paper is to describe the advantages and disadvantages of the known medication adherence tools (self-report, pill count, medication event monitoring system (MEMS) and electronic monitoring devices, therapeutic drug monitoring, pharmacy records based on pharmacy refill and pharmacy claims databases) to provide the appropriate criteria to assess medication adherence in older persons. To the best of our knowledge, no gold standard has been identified in adherence measurement and no single method is sufficiently reliable and accurate. A combination of methods appears to be the most suitable. Secondly, adherence assessment should always consider tools enabling polypharmacy adherence assessment. Moreover, it is increasingly evident that adherence, as a process, has to be assessed over time and not just at one evaluation time point (drug discontinuation). When cognitive deficits or functional impairments may impair reliability of adherence assessment, a comprehensive geriatric assessment should be performed and the caregiver involved. Finally, studies considering the possible implementation in clinical practice of adherence assessment tools validated in research are needed.
AB - Nonadherence to medication regimens is a worldwide challenge; adherence rates range from 38 to 57 % in older populations with an average rate of less than 45 % and nonadherence contributes to adverse drug events, increased emergency visits and hospitalisations. Accurate measurement of medication adherence is important in terms of both research and clinical practice. However, the identification of an objective approach to measure nonadherence is still an ongoing challenge. The aim of this Position Paper is to describe the advantages and disadvantages of the known medication adherence tools (self-report, pill count, medication event monitoring system (MEMS) and electronic monitoring devices, therapeutic drug monitoring, pharmacy records based on pharmacy refill and pharmacy claims databases) to provide the appropriate criteria to assess medication adherence in older persons. To the best of our knowledge, no gold standard has been identified in adherence measurement and no single method is sufficiently reliable and accurate. A combination of methods appears to be the most suitable. Secondly, adherence assessment should always consider tools enabling polypharmacy adherence assessment. Moreover, it is increasingly evident that adherence, as a process, has to be assessed over time and not just at one evaluation time point (drug discontinuation). When cognitive deficits or functional impairments may impair reliability of adherence assessment, a comprehensive geriatric assessment should be performed and the caregiver involved. Finally, studies considering the possible implementation in clinical practice of adherence assessment tools validated in research are needed.
KW - Adherence
KW - Chronic diseases
KW - Elderly
KW - Nonadherence
KW - Polypharmacy
KW - Tools
UR - http://www.scopus.com/inward/record.url?scp=84973901348&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84973901348&partnerID=8YFLogxK
U2 - 10.1007/s40520-015-0435-z
DO - 10.1007/s40520-015-0435-z
M3 - Review article
AN - SCOPUS:84973901348
VL - 28
SP - 371
EP - 381
JO - Aging clinical and experimental research
JF - Aging clinical and experimental research
SN - 1594-0667
IS - 3
ER -