Medication Adherence Promotion (MAP)
Strengths and Weaknesses of Adherence Measurement

Strengths and Weaknesses of Adherence Measurement

Measurement Method	Strengths	Weaknesses
Self-Report Questionnaires/ Structured Interviews	Easy to complete Inexpensive Comprehensive & flexible Available for multiple informants	Overestimates due to reporting biases (“faking good”) Recall problems Global estimates of behavior Not useful for younger children
Electronic Monitors	Precise record of date, time and duration Continuous, long-term measurement Identification of patterns of non-adherence Feedback to patients and families on rates adherence	Technical problems Expense Assumes medication was ingested Patient reactivity Not available for all treatments (e.g., food intake)
Pharmacy Refill History	Specifies type and amount of medication that was filled No patient burden	Does not indicate that medication was taken Limited to medication regimens Can require collecting data from multiple pharmacies Difficult to obtain given HIPAA Guidelines
Biological Assays	Objectively verifies drug ingestion No reporting biases or recall problems Quantifiable	Instability of blood levels due to metabolism, food intake, etc. Pharmacokinetic variations Invasive Expensive Not useful for all chronic conditions
Smart Phone Apps	Aids the users in tracking adherence Can generate alerts to remind users to take or record taking medication Can be a motivation aid	Limited effectiveness Depended on the patient owning a smartphone or tablet Not available for all treatments

End of Module 3