Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 3;18(9):4872.
doi: 10.3390/ijerph18094872.

Persistence as a Robust Indicator of Medication Adherence-Related Quality and Performance

Enrica Menditto  1 , Caitriona Cahir  2 , Sara Malo  3 , Isabel Aguilar-Palacio  3 , Marta Almada  4 , Elisio Costa  4 , Anna Giardini  5 , María Gil Peinado  6 , Mireia Massot Mesquida  7 , Sara Mucherino  1 , Valentina Orlando  1 , Carlos Luis Parra-Calderón  8 , Enrique Pepiol Salom  9 , Przemyslaw Kardas  10 , Bernard Vrijens  11
Affiliations

Persistence as a Robust Indicator of Medication Adherence-Related Quality and Performance

Enrica Menditto et al. Int J Environ Res Public Health. .

Abstract

Medication adherence is a priority for health systems worldwide and is widely recognised as a key component of quality of care for disease management. Adherence-related indicators were rarely explicitly included in national health policy agendas. One barrier is the lack of standardised adherence terminology and of routine measures of adherence in clinical practice. This paper discusses the possibility of developing adherence-related performance indicators highlighting the value of measuring persistence as a robust indicator of quality of care. To standardise adherence and persistence-related terminology allowing for benchmarking of adherence strategies, the European Ascertaining Barriers for Compliance (ABC) project proposed a Taxonomy of Adherence in 2012 consisting of three components: initiation, implementation, discontinuation. Persistence, which immediately precedes discontinuation, is a key element of taxonomy, which could capture adherence chronology allowing the examination of patterns of medication-taking behaviour. Advances in eHealth and Information Communication Technology (ICT) could play a major role in providing necessary structures to develop persistence indicators. We propose measuring persistence as an informative and pragmatic measure of medication-taking behaviour. Our view is to develop quality and performance indicators of persistence, which requires investing in ICT solutions enabling healthcare providers to review complete information on patients' medication-taking patterns, as well as clinical and health outcomes.

Keywords: electronic health records; medication adherence; performance indicator; persistence; quality of care.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Phases of medication adherence according to the ABC Taxonomy. Based on Vrijens et al., Br. J. Clin. Pharmacol. 2012 [13].
See this image and copyright information in PMC

References

    1. Osterberg L., Blaschke T. Adherence to medication. N. Engl. J. Med. 2005;353:487–497. doi: 10.1056/NEJMra050100. - DOI - PubMed
    1. Stirratt M.J., Curtis J.R., Danila M.I., Hansen R., Miller M.J., Gakumo C.A. Advancing the Science and Practice of Medication Adherence. J. Gen. Intern. Med. 2018;33:216–222. doi: 10.1007/s11606-017-4198-4. - DOI - PMC - PubMed
    1. Menditto E., Orlando V., De Rosa G., Minghetti P., Musazzi U.M., Cahir C., Kurczewska-Michalak M., Kardas P., Costa E., Lobo J.M.S., et al. Patient Centric Pharmaceutical Drug Product Design-The Impact on Medication Adherence. Pharmaceutics. 2020;12:44. doi: 10.3390/pharmaceutics12010044. - DOI - PMC - PubMed
    1. European Commission Competition DG 8th Report on the Monitoring of Patent Settlements. [(accessed on 5 February 2021)]; Available online: http://ec.europa.eu/competition/sectors/pharmaceuticals/inquiry/index.html.
    1. World Health Organization (WHO) Adherence to Long-Term Therapies: Evidence for Action. World Health Organization (WHO); Geneva, Switzerland: 2003.