Patient Adherence Analysis

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Detection of patient’s adherence:
No single gold standard technique available to measure the adherence behavior by patients. 23 Adherence can be measured by using direct and\or indirect methods. 11, 24-26
Direct methods include measuring levels of drug \ drug’s metabolite in blood or urine. 24,25 Although direct methods seem to be accurate in detecting patient’s adherence, this approach is expensive and difficult to apply on routine clinical follow-up. 24
On the other hand, indirect methods of adherence detection include patients’ questionnaires, patients’ self-reports, pill counts, use of patient diaries 27,24,28 , rates of prescriptions refills, assessment of patients’ clinical response and electronic medication monitors. 29,30
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But these methods are not always authentic. For example, pill counts (counting remaining number of pills in the bottle) doesn’t always indicate that the patient has really taken the medication, some patients can discard pills before hospital visit to appear to be adherent to the prescribed regimen. 31-33 Also, pill counting doesn’t ensure that the drug was at the correct timing of administration.
So, it is important to note that no single method is better and preferred over the other, rather a combination of these techniques is recommended to achieve the best results. 34
Medication adherence rates:
Several methods available to measure the rates of medication adherence among patients, these methods include:
1- Measuring the percentage of prescribed doses actually taken by the patient over a specified period of time. 24
2- Measuring the average number of: 25 a- Missed doses. b- Doses taken incorrectly (ex. incorrect time of administration). c- Drugs without taking the prescribed