Medication Adherence: A Literature Review

Charlotte A. Kenreigh, PharmD, and Linda Timm Wagner, PharmD


October 12, 2005

In This Article

HIV/AIDS Patients

A descriptive study of electronic monitoring devices (EMD) in HIV-infected patients treated with highly active antiretroviral therapy (HAART) examined 128 patients over a 12-month period.[9] Patients were asked to place their prescriptions in a container with an EMD and complete an end-of-study questionnaire.

In this population, the biggest reason patients gave for not using the EMD as instructed was the concomitant use of pillboxes. At the onset of the study, patients agreed to open the EMD cap when they took medications out of a pillbox so the EMD would record the dose. However, patients who used a pillbox for their medication storage sometimes forgot to open the EMD at the corresponding time. Use of pillboxes accounted for about 20% of missed EMD data.

On the basis of patient responses to the questionnaire as well as researcher concerns, the authors constructed a 17-item list of practical recommendations for using EMDs to measure adherence.[9] Of particular interest to pharmacists is the recommendation to avoid the use of EMDs in populations that rely heavily on pillboxes. As pillboxes are often used as adherence tools for patients with numerous medications, EMDs may not be beneficial adjunctive interventions in these populations.


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