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Review
. 2019 Apr;79(6):647-654.
doi: 10.1007/s40265-019-01107-y.

Distinct Profiles on Subjective and Objective Adherence Measures in Patients Prescribed Antidepressants

Hans Wouters  1   2 , Didi Rhebergen  3 , Marcia Vervloet  4 , Antoine Egberts  5   6 , Katja Taxis  7 , Liset van Dijk  7   4 , Helga Gardarsdottir  5   6   8
Affiliations
Review

Distinct Profiles on Subjective and Objective Adherence Measures in Patients Prescribed Antidepressants

Hans Wouters et al. Drugs. 2019 Apr.

Abstract

Objective: A recurrent observation is that associations between self-reported and objective medication adherence measures are often weak to moderate. Our aim was therefore to identify patients with different profiles on self-reported and objective adherence measures.

Study design and setting: This was an observational study of 221 community pharmacy patients who were dispensed antidepressants. Adherence profiles were estimated with Latent Profile Analysis (LPA) using data on self-reported adherence (Medication Adherence Rating Scale) complemented with data on medication beliefs (perceived necessity and concerns measured with the Beliefs about Medicines Questionnaire) and data from objective adherence measures (electronic monitoring of medication taking and the Medication Possession Ratio calculated from pharmacy dispensing data).

Results: 'Goodness-of-fit' statistics indicated the presence of three classes: "concordantly high adherent" (83%, high adherence on all measures), "concordantly suboptimal adherent" (11%, low adherence on all measures), and "discordant" (6%, high self-reported adherence but lower adherence on objective measures).

Conclusion: Most patients had concordant outcomes on self-reported and objective measures of adherence. A small discordant class had high self-reported but low objective adherence. LPA will enable sensitivity analyses in future studies, for example excluding patients from the discordant class.

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Conflict of interest statement

Conflict of interest

The authors report no other conflicts of interest.

Ethical standards

All procedures performed in this study were in accordance with the ethical standards of the medical ethics committee of the University Medical Center of Utrecht, which approved the study, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all individual participants who were included in the study.

Figures

Fig. 1
Fig. 1
Time window of data from different adherence measures being collected
Fig. 2
Fig. 2
Scoring profiles of patient classes on adherence measures. *Values on adherence measures are expressed as percentages to facilitate mutual comparisons between different adherence measures. MARS Medication Adherence Rating Scale, MEMS Medication Event Monitoring System, MPR Medication Possession Ratio
See this image and copyright information in PMC

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