Medical Therapeutic Adherence Measure

An Medical Therapeutic Adherence Measure is a measure of a patient correctly following medical therapeutic protocol.

• AKA: Treatment Adherence.
• Context:
  • output: a Treatment Adherence Value, such as low treatment adherence.
  • It can range from being a Medication Usage Adherence (for a medication) to being Medical Device Usage Adherence (for a medical device).
  • It can range from being a Short-Term to being a Long-Term .
  • …
• Example(s):
  • a Clinical Trial Therapeutic Adherence Measure (a clinical trial measure), such as a Clinical Trial Drug Treatment Adherence Measure.
  • …
• Counter-Example(s):
  • Medical Concordance.
• See: Clinical Trial Engagement Measure, Developed Countries, Asthma, Diabetes.

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References

2022

• (Wikipedia, 2022) ⇒ https://en.wikipedia.org/wiki/adherence#Healthcare Retrieved:2022-8-13.
  • Adherence (medicine), the obedience of the patient to the medical advice

2022

• (Wikipedia, 2022) ⇒ https://en.wikipedia.org/wiki/adherence_(medicine) Retrieved:2022-8-13.
  • In medicine, patient compliance (also adherence, capacitance) describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions. Both patient and health-care provider affect compliance, and a positive physician-patient relationship is the most important factor in improving compliance. Access to care plays a role in patient adherence, whereby greater wait times to access care contributing to greater absenteeism. The cost of prescription medication also plays a major role. Compliance can be confused with concordance, which is the process by which a patient and clinician make decisions together about treatment. Worldwide, non-compliance is a major obstacle to the effective delivery of health care. 2003 estimates from the World Health Organization indicated that only about 50% of patients with chronic diseases living in developed countries follow treatment recommendations with particularly low rates of adherence to therapies for asthma, diabetes, and hypertension. Major barriers to compliance are thought to include the complexity of modern medication regimens, poor "health literacy" and not understanding treatment benefits, occurrence of undiscussed side effects, poor treatment satisfaction, cost of prescription medicine, and poor communication or lack of trust between a patient and his or her health-care provider. Efforts to improve compliance have been aimed at simplifying medication packaging, providing effective medication reminders, improving patient education, and limiting the number of medications prescribed simultaneously. Studies show a great variation in terms of characteristics and effects of interventions to improve medicine adherence. It is still unclear how adherence can consistently be improved in order to promote clinically important effects.

2012

• (Barbosaias et al., 2012) ⇒ Carla D. Barbosaias, Maria-Magdalena Balp, Károly Kulich, Nicola Germain, and Diana Rofail. (2012). “A Literature Review to Explore the Link Between Treatment Satisfaction and Adherence, Compliance, and Persistence.” In: Patient Preference and Adherence, 6.
  • QUOTE: ... This review identified few studies that evaluate the statistical association between satisfaction and adherence, compliance, or persistence. The available data suggested that greater treatment satisfaction was associated with better compliance and improved persistence, and with lower regimen complexity or treatment burden. ...
  • … The articles included in this review did not provide a consensus on definitions of adherence, compliance, or persistence. Various definitions were used for these terms, often interchangeably across publications. For example, eleven studies measured compliance, that is to say the quality of drug regimen execution, by asking questions about missing doses, forgetting doses, or skipping doses, or using “objective” measures such electronic system or pill count, but called it adherence. The multidimensional term of adherence was rarely measured using a questionnaire that measures the concept in its entirety, as defined by the World Health Organization.1

2021

• https://www.breakthroughchangeaccelerator.com/clinical-study-adherence
  • QUOTE: ... Study participants not adhering to their investigational product regimen results in:
    • Increased the number of patients required to complete a study​
    • Increased costs (higher site and patient recruitment)​
    • Increased time to complete the study.
    • Increased investigational products overage and associated costs
  • Challenge Statement

    We are looking for new, innovative patient-friendly solutions for continuous improvement of investigational product adherence in clinical trials. The solution should also allow for the prediction, assessment, and identification of potential risk factors contributing to clinical trial non-adherence in clinical trial participants. ...

2018

• (Coravos, 2018) ⇒ Andrea Coravos (January 23, 2018). “Clinical trials are in need of a digital makeover". In: Digital Initiative - Harvard Business School.
  • QUOTE: ... Outcomes are also influenced by med adherence technologies, and there are a number of new tools that are designed to improve adherence. AiCure is an advanced medication adherence solution powered by artificial intelligence, which visually confirms medication ingestion on any smartphone. Dan Gebremedhin and Kara Werner from Flare Capital recently conducted a deep-dive in medical adherence tools on the market. These types of technologies are in many ways more similar to digital biomarkers than to the big patient data capture databases. ...

2012

• (Kelders et al., 2012) ⇒ Saskia M. Kelders, Robin N. Kok, Hans C. Ossebaard, and Julia EWC Van Gemert-Pijnen. (2012). “Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-based Interventions.” Journal of medical Internet Research, 14(6).
  • QUOTE: ... A percentage of adherence was calculated to enable us to compare the different interventions. We did this by calculating the percentage of participants that adhered to the intervention. For example, when the intended use of an intervention was “complete 8 modules” and 60 out of 100 participants completed 8 modules, the adherence was 60%. For each intervention that was included, we calculated one overall adherence percentage. When more studies about the same intervention yielded different adherence percentages, we calculated the overall adherence percentage using a weighted average, based on the number of participants in each study. Furthermore, when the study included a waiting list and the respondents in this waiting list received access to the intervention at a later stage, the adherence was calculated based on usage data for all participants, including the waiting list group. ...

2006

• (Reginster et al., 2006) ⇒ Jean-Yves Reginster, Véronique Rabenda, and Audrey Neuprez. (2006). “Adherence, Patient Preference and Dosing Frequency: Understanding the Relationship.” Bone 38, no. 4
  • QUOTE: Adherence to treatment among patients with chronic diseases is currently suboptimal. Poor adherence leads to reduced clinical benefit, a raised incidence of secondary complications and therefore increased healthcare costs. For patients with osteoporosis, long-term adherence to therapy is further complicated by the asymptomatic nature of the disease and the lack of options for patient self-monitoring. Bone densitometry and biochemical markers of bone turnover are assessments that could be used by physicians to provide feedback to patients on the effectiveness of medication. However, these feedback systems are costly and not readily available.

2003

• World Health Organization. (2003). "Adherence to Long-Term Therapies: evidence for action". World Health Organization, 2003.
  • QUOTE: ... Adherence to therapies is a primary determinant of treatment success. Poor adherence attenuates optimum clinical benefits and therefore reduces the overall effectiveness of health systems.

    Medicines will not work if you do not take them. Medicines will not be effective if patients do not follow prescribed treatment - yet in developed countries only 50% of patients who suffer from chronic diseases adhere to treatment recommendations. In developing countries, when taken together with poor access to health care, lack of appropriate diagnosis, and limited access to medicines, poor adherence is threatening to render futile any effort to tackle chronic conditions such as diabetes, depression and HIV/AIDS. ...

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