Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Poor medication adherence attenuates optimal clinical benefits and reduces the overall effectiveness of health systems. A large number of interventions targeting medication adherence have been evaluated in randomized controlled trials (RCTs). However, there is no consensus on which adherence related outcomes should be used in these RCTs. We sought to assess the scope and consistency of adherence related outcome domains and measures in RCTs of medication adherence interventions.
Methods: Four reviewers independently extracted the adherence outcome domains and measures from RCTs included in the 2014 Cochrane review of interventions for enhancing medication adherence. Adherence as an outcome domain was classified into phases (using the ABC taxonomy these were divided into initiation, implementation, persistence or phase unclear). The time points, metric and method of aggregation of each outcome measure were also extracted. Contextual factors (any factor that may affect adherence but not measuring adherence itself) were also extracted.
Results: From 70 trials, the four adherence outcome domains (initiation, implementation, persistence and phase unclear) were measured using 68 different adherence measures, with a mean of 2 adherence measures per trial (range 1-5). For adherence outcome domains, implementation adherence was reported most frequently (61 trials [87%]), followed by persistence adherence (7 trials [10%]) and initiation adherence (2 trials [3%]). The phase of adherence being measured was unclear in 15 trials [21%]. There were 37 different contextual factors. The six most common contextual factors reported were disease knowledge (7 trials [10%]), medication knowledge (5 trials [7%]), lifestyle adherence (5 trials [7%]), medication satisfaction (4 trials [6%]), clinical care satisfaction (4 trials [6%]), and self efficacy (4 trials [6%]).
Conclusion: Implementation adherence is the primary type of adherence outcome domain reported. Adherence measures in RCTs are heterogeneous with a lack of uniformity. Many other factors that may be relevant to adherence are being reported in RCTs however their importance needs further evaluation. Additional work to ensure consistent reporting of robust outcome domains and measures that are relevant to all stakeholders, particularly patients, will improve the value of clinical trials in supporting evidence-based decision-making regarding medication adherence.
To cite this abstract in AMA style:
Kelly A, Sumpton D, O'Sullivan C, Meara A, Nieuwlaat R, Tugwell P, March L, Tong A, Toupin-April K, Nantel F, Van den Bemt (PharmD PhD) BJF, De Vera M, Evans V, Campbell W, Wong P, Davey R, Beaton D, Suarez-Almazor M, Hassett G, Keen HI, Dawson T, Crimston-Smith L, Tymms K. Scope and Consistency of Adherence Related Outcomes in Randomized Controlled Trials of Interventions for Improving Medication Adherence [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/scope-and-consistency-of-adherence-related-outcomes-in-randomized-controlled-trials-of-interventions-for-improving-medication-adherence/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/scope-and-consistency-of-adherence-related-outcomes-in-randomized-controlled-trials-of-interventions-for-improving-medication-adherence/