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. 2008 Sep-Oct;9(5):298-308.
doi: 10.1310/hct0905-298.

Monitoring medication adherence by unannounced pill counts conducted by telephone: reliability and criterion-related validity

Seth C Kalichman  1 , Christina M Amaral, Chauncey Cherry, Jody Flanagan, Howard Pope, Lisa Eaton, Moira O Kalichman, Demetria Cain, Mervi Detorio, Angela Caliendo, Raymond F Schinazi
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Monitoring medication adherence by unannounced pill counts conducted by telephone: reliability and criterion-related validity

Seth C Kalichman et al. HIV Clin Trials. 2008 Sep-Oct.

Abstract

Background: Although demonstrated valid for monitoring medication adherence, unannounced pill counts conducted in patients' homes are costly and logistically challenging. Telephone-based unannounced pill counts offer a promising adaptation that resolves most of the limitations of home-based pill counting.

Purpose: We tested the reliability and criterion-related validity of a telephone-based unannounced pill count assessment of antiretroviral adherence.

Method: HIV-positive men and women (N = 89) in Atlanta, Georgia, completed a telephone-based unannounced pill count and provided contemporaneous blood specimens to obtain viral loads; 68 participants also received an immediate second pill count conducted during an unannounced home visit.

Results: A high degree of concordance was observed between the number of pills counted on the telephone and in the home (intraclass correlation [ICC] = .981, p < .001) and percent of pills taken (ICC = .987, p < .001). Adherence obtained by the telephone count and home count reached 92% agreement (Kappa coefficient = .94). Adherence determined by telephone-based pill counts also corresponded with patient viral load, providing evidence for criterion-related validity.

Conclusion: Unannounced telephone-based pill counts offer a feasible objective method for monitoring medication adherence.

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Figure 1
Figure 1
Participant flow through the study.
See this image and copyright information in PMC

References

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