A scoping review of studies comparing the medication event monitoring system (MEMS) with alternative methods for measuring medication adherence

Mohamed El Alili, Bernard Vrijens, Jenny Demonceau, Silvia M Evers, Mickael Hiligsmann

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Different methods are available for measuring medication adherence. In this paper, we conducted a scoping review to identify and summarize evidence of all studies comparing the Medication Event Monitoring System (MEMS) with alternative methods for measuring medication adherence. A literature search was performed using the open database www.iAdherence.org that includes all original studies reporting findings from the MEMS. Papers comparing methods for measuring adherence to solid oral formulations were included. Data was extracted using a standardized extraction table. A total of 117 articles fulfilled the inclusion criteria, including 251 comparisons. Most frequent comparisons were against self-report (n = 119) and pill count (n = 59). Similar outcome measures were used in 210 comparisons (84%), among which 78 used dichotomous variables (adherent or not) and 132 used continuous measures (adherence expressed as percentage). Furthermore, 32% of all comparisons did not estimate adherence over the same coverage period and 44% of all comparisons did not use a statistical method or used a suboptimal one. Only eighty-seven (35%) comparisons had similar coverage periods, similar outcome measures and optimal statistical methods. Compared to MEMS, median adherence was grossly overestimated by 17% using self-report, by 8% using pill count and by 6% using rating. In conclusion, among all comparisons of MEMS versus alternative methods for measuring adherence, only a few used adequate comparisons in terms of outcome measures, coverage periods and statistical method. Researchers should therefore use stronger methodological frameworks when comparing measurement methods and be aware that non-electronic measures could lead to overestimation of medication adherence.

Original languageEnglish
Pages (from-to)268-79
Number of pages12
JournalBritish Journal of Clinical Pharmacology
Volume82
Issue number1
DOIs
Publication statusPublished - Jul 2016

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Medication Adherence
Outcome Assessment (Health Care)
Self Report
Research Personnel
Databases

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  • Journal Article

Cite this

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title = "A scoping review of studies comparing the medication event monitoring system (MEMS) with alternative methods for measuring medication adherence",
abstract = "Different methods are available for measuring medication adherence. In this paper, we conducted a scoping review to identify and summarize evidence of all studies comparing the Medication Event Monitoring System (MEMS) with alternative methods for measuring medication adherence. A literature search was performed using the open database www.iAdherence.org that includes all original studies reporting findings from the MEMS. Papers comparing methods for measuring adherence to solid oral formulations were included. Data was extracted using a standardized extraction table. A total of 117 articles fulfilled the inclusion criteria, including 251 comparisons. Most frequent comparisons were against self-report (n = 119) and pill count (n = 59). Similar outcome measures were used in 210 comparisons (84{\%}), among which 78 used dichotomous variables (adherent or not) and 132 used continuous measures (adherence expressed as percentage). Furthermore, 32{\%} of all comparisons did not estimate adherence over the same coverage period and 44{\%} of all comparisons did not use a statistical method or used a suboptimal one. Only eighty-seven (35{\%}) comparisons had similar coverage periods, similar outcome measures and optimal statistical methods. Compared to MEMS, median adherence was grossly overestimated by 17{\%} using self-report, by 8{\%} using pill count and by 6{\%} using rating. In conclusion, among all comparisons of MEMS versus alternative methods for measuring adherence, only a few used adequate comparisons in terms of outcome measures, coverage periods and statistical method. Researchers should therefore use stronger methodological frameworks when comparing measurement methods and be aware that non-electronic measures could lead to overestimation of medication adherence.",
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A scoping review of studies comparing the medication event monitoring system (MEMS) with alternative methods for measuring medication adherence. / El Alili, Mohamed; Vrijens, Bernard; Demonceau, Jenny; Evers, Silvia M; Hiligsmann, Mickael.

In: British Journal of Clinical Pharmacology, Vol. 82, No. 1, 07.2016, p. 268-79.

Research output: Contribution to JournalArticleAcademicpeer-review

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