The Concordance of Self-Report With Other Measures of Medication Adherence: A Summary of the Literature

Objective:The objective of this study was to evaluate the concordance of self-report measures of medication adherence (interview, diary, or questionnaire) with nonself-report measures of adherence (administrative claims, pill count or canister weight, plasma drug concentration, electronic monitors, or clinical opinion). Methods:A literature search was conducted to identify published reports in which self-report and nonself-report measures of adherence were used within the same study. The concordance of measures within each study was categorized as high, moderate, or low based on a comparison of the adherence estimates. Results:Eight-six comparisons of self-report to nonself-report measures of adherence were identified. Thirty-seven of the 86 comparisons (43%) were categorized as highly concordant. However, concordance varied substantially by type of self-report measure and nonself-report measure. Self-report measures, in general, were highly concordant with electronic measures in only 17% of comparisons, whereas they were highly concordant with other types of nonself-report measures in 58% of comparisons (chi-square = 14.30, P <0.01). When comparing self-report measures, interviews had significantly lower concordance with nonself-report measures as compared with questionnaires or diaries (chi-square = 8.47, P = 0.01). In 15 comparisons of interviews with electronic measures, none of the comparisons were highly concordant, whereas questionnaires and diaries had moderate-to-high concordance with electronic measures in 12 of 16 comparisons (75%). Conclusions:The concordance of self-report and other measures of medication adherence varies widely based on the type of measures used. Questionnaires and diaries tend to have moderate-to-high concordance with other measures of medication adherence. However, interview-based self-reports are not concordant with electronic measures. Questionnaire and diary methods could be preferable to interviews for self-reported medication adherence.

[1]  A. O. Hughes,et al.  Clinical epidemiology a basic science for clinical medicine (2nd edition). David L. Sackett, R. Brian Haynes, Gordon H. Guyatt, Peter Tugwell, Little Brown and company, Bosten, 1991. no. of pages: xvii+441. price: £23.95, $32.50. ISBn: 0316‐76599‐6 , 1993 .

[2]  Peter P. Morgan,et al.  Compliance in Health Care , 1979 .

[3]  Judith A. Hall,et al.  Effectiveness of interventions to improve patient compliance: a meta-analysis. , 1998, Medical care.

[4]  K. Farmer,et al.  Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. , 1999, Clinical therapeutics.

[5]  Leonard H. Epstein,et al.  Developmental aspects of health compliance behavior , 1993 .

[6]  H. Mcdonald,et al.  Interventions to enhance patient adherence to medication prescriptions: scientific review. , 2002, JAMA.

[7]  D. Sackett,et al.  The Ends of Human Life: Medical Ethics in a Liberal Polity , 1992, Annals of Internal Medicine.

[8]  Jacob Cohen,et al.  Applied multiple regression/correlation analysis for the behavioral sciences , 1979 .

[9]  Peter Y. Chen,et al.  Correlation: Parametric and Nonparametric Measures , 2002 .

[10]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[11]  H. Hricak,et al.  Evidence-based medicine. , 1997, Singapore medical journal.

[12]  M. Robin DiMatteo,et al.  Patient Adherence and Medical Treatment Outcomes: A Meta-Analysis , 2002, Medical care.

[13]  J. Dunbar-Jacob,et al.  Treatment adherence in chronic disease. , 2001, Journal of clinical epidemiology.

[14]  D. Nau,et al.  Congruence of Three Self-Report Measures of Medication Adherence among HIV Patients , 2000, The Annals of pharmacotherapy.

[15]  Ronald G. Askin Handbook for Linear Regression , 1980 .