16 July 2024 : Review article
Innovative Approaches to Enhance and Measure Medication Adherence in Chronic Disease Management: A Review
Michał Gackowski
1ABEF*, Magdalena Jasińska-Stroschein 2AE, Tomasz Osmałek 1AE, Magdalena Waszyk-Nowaczyk 3AEG
DOI: 10.12659/MSM.944605
Med Sci Monit 2024; 30:e944605
Introduction
Overview of Medication Adherence Measurements Models
Healthcare Assessment
Self-Reporting
Drug Level Measures
Pill Count
Electronic Medication Packaging (EMP) Devices
Directly Observed Therapy (DOT)
Secondary Database Measurements
Mobile Applications and Artificial Intelligence
Video Observed Therapy (VOT)
Mobile Health Applications (MHealth Apps)
Questionnaires and Scales
New Developments in Adherence Monitoring Packages (EMPs)
Medication Event Monitoring System (MEMS)
Wisepill Device
SMARxT Cap
One-Dose Package Medication Support System (ODP-MSS)
ReX
Smart Blister Packs
SmartMed
Time4Med
Smart Pens
Smart Inhaler
Ingestible Biosensors (IS)
Future Initiatives
Conclusions
References
Table 4 Conclusions drawn from the literature review on selected methods for assessing patients’ medication adherence.
| No. | Conclusion |
|---|---|
| 1 | No established method is recognized as the criterion standard; each has strengths and limitations |
| 2 | Questionnaires and scales to assess patients’ self-reported adherence must be adapted to the specific disease (or group of diseases). In addition, most of the instrumentspresented only fulfill some of the psychometric properties to be recognized as leading in the group of diseases. Nevertheless, the MMAS questionnaire is one of the most widely used tools, regardless of the type of disease for which it is used |
| 3 | Electronic medication packaging devices have proliferated, becoming more manageable, portable, and acceptable to patients. Advances in developing devices for non-solid forms (inhalers, injectables) allow adherence measurement that was impossible before |
| 4 | Artificial intelligence and machine learning mechanisms are used to create algorithms to monitor patient adherence independently. Intelligent platforms can pre-diagnose patient adherence, enabling rapid identification of non-adherence risks |
| 5 | Ingestible biosensors offer accurate adherence measurement with minimal risk of falsifying results. Limited clinical trials using biosensors make assessing their usefulness in daily practice difficult |
| 6 | Objective methods cannot determine why a patient is non-adherent; subjective methods like questionnaires are needed |
| 7 | A multidisciplinary approach combining objective and subjective methods can fill the missing criterion standard. This approach is often complex, expensive, and unsuitable for daily practice, with limited impact on self-management |