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Assessing Medication Adherence in the Elderly

Which Tools to Use in Clinical Practice?

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Abstract

Adherence to prescribed medication regimens is difficult for all patients and particularly challenging for the elderly. Medication adherence demands a working relationship between a patient or caregiver and prescriber that values open, honest discussion about medications, i.e. the administration schedule, intended benefits, adverse effects and costs.

Although nonadherence to medications may be common among the elderly, fundamental reasons leading to nonadherence vary among patients. Demographic characteristics may help to identify elderly patients who are at risk for nonadherence. Inadequate or marginal health literacy among the elderly is common and warrants assessment. The number of co-morbid conditions and presence of cognitive, vision and/or hearing impairment may predispose the elderly to nonadherence. Similarly, medications themselves may contribute to nonadherence secondary to adverse effects or costs. Especially worrisome is nonadherence to ‘less forgiving’ drugs that, when missed, may lead to an adverse event (e.g. withdrawal symptoms) or disease exacerbation.

Traditional methods for assessing medication adherence are unreliable. Direct questioning at the patient interview may not provide accurate assessments, especially if closed-ended, judgmental questions are posed. Prescription refill records and pill counts often overestimate true adherence rates. However, if elders are asked to describe how they take their medicines (using the Drug Regimen Unassisted Grading Scale or MedTake test tools), adherence problems can be identified in a nonthreatening manner.

Medication nonadherence should be suspected in elders who experience a decline in functional abilities. Predictors of medication nonadherence include specific disease states, such as cardiovascular diseases and depression. Technological aids to assessing medication adherence are available, but their utility is, thus far, primarily limited to a few research studies. These computerised devices, which assess adherence to oral and inhaled medications, may offer insight into difficult medication management problems. The most practical method of medication adherence assessment for most elderly patients may be through patient or caregiver interview using open-ended, nonthreatening and nonjudgmental questions.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. Haynes RB, McDonald H, Garg AX, et al. Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev 2002; (2): CD000011

    Google Scholar 

  2. McDonald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions: scientific review. JAMA 2002; 288: 2868–79

    Article  PubMed  Google Scholar 

  3. Roter DL, Hall JA, Merisca R, et al. Effectiveness of interventions to improve patient compliance: a meta analysis. Med Care 1998; 36: 1138–61

    Article  PubMed  CAS  Google Scholar 

  4. van Eijken M, Tsang S, Wensing M, et al. Interventions to improve medication compliance in older patients living in the community: a systematic review of the literature. Drugs Aging 2003; 20: 229–40

    Article  PubMed  Google Scholar 

  5. Urquhart J, Chevalley C. Impact of unrecognized dosing errors on the cost and effectiveness of pharmaceuticals. Drug Inf J 1988; 22: 363–78

    Google Scholar 

  6. Peterson AM, Takiya L, Finley R. Meta-analysis of trials of interventions to improve medication adherence. Am J Health Syst Pharm 2003; 60: 657–65

    PubMed  Google Scholar 

  7. Merriam-Webster. Merriam-Webster online dictionary [online]. Available from URL: http://www.m-w.com/cgi-bin/dictionary?.book=Dictionary&va=compliance [Accessed 2004 Mar 30]

  8. Urquhart J. Role of patient compliance in clinical pharmacokinetics: a review of recent research. Clin Pharmacokinet 1994; 27: 202–15

    Article  PubMed  CAS  Google Scholar 

  9. Col N, Fanale JE, Kronholm P. The role of medication noncompliance and adverse drug reactions in hospitalizations of the elderly. Arch Intern Med 1990; 150: 841–5

    Article  PubMed  CAS  Google Scholar 

  10. Chan M, Nicklason F, Vial JH. Adverse drug events as a cause of hospital admission in the elderly. Intern Med J 2001; 31: 199–205

    Article  PubMed  CAS  Google Scholar 

  11. Morrow D, Leirer V, Sheikh J. Adherence and medication instructions: review and recommendations. J Am Geriatr Soc 1988; 36: 1147–60

    PubMed  CAS  Google Scholar 

  12. Gray SL, Mahoney JE, Blough DK. Medication adherence in elderly patients receiving home health services following hospital discharge. Ann Pharmacother 2001; 35: 539–45

    Article  PubMed  CAS  Google Scholar 

  13. Cramer JA. Microelectronic systems for monitoring and enhancing patient compliance with medication regimens. Drugs 1995; 49: 321–7

    Article  PubMed  CAS  Google Scholar 

  14. Balkrishnan R. Predictors of medication adherence in the elderly. Clin Ther 1998; 20: 764–71

    Article  PubMed  CAS  Google Scholar 

  15. Cooper JK, Love DW, Raffoul PR. Intentional prescription nonadherence (noncompliance) by the elderly. J Am Geriatr Soc 1982; 30: 329–33

    PubMed  CAS  Google Scholar 

  16. Coons SJ, Sheahan SL, Martin SS, et al. Predictors of medication noncompliance in a sample of older adults. Clin Ther 1994; 16: 110–7

    PubMed  CAS  Google Scholar 

  17. Monane M, Bohn RL, Gurwitz JH, et al. Compliance with antihypertensive therapy among elderly Medicaid enrollees: the roles of age, gender, and race. Am J Public Health 1996; 86: 1805–8

    Article  PubMed  CAS  Google Scholar 

  18. Billups SJ, Malone DC, Carter BL. The relationship between drug therapy noncompliance and patient characteristics, health-related quality of life, and health care costs. Pharmacotherapy 2000; 20: 941–9

    Article  PubMed  CAS  Google Scholar 

  19. Park DC, Morrell RW, Frieske D, et al. Medication adherence behaviors in older adults: effects of external cognitive supports. Psychol Aging 1992; 7: 252–6

    Article  PubMed  CAS  Google Scholar 

  20. Andrus MR, Roth MT. Health literacy: a review. Pharmacotherapy 2002; 22: 282–302

    Article  PubMed  Google Scholar 

  21. Baker DW, Gazmararian JA, Sudano J, et al. The association between age and health literacy among elderly persons. J Gerontol B Psychol Sci Soc Sci 2000; 55: S368–74

    Article  PubMed  CAS  Google Scholar 

  22. Gazmararian JA, Baker DW, Williams MV, et al. Health literacy among Medicare enrollees in a managed care organization. JAMA 1999; 281: 545–51

    Article  PubMed  CAS  Google Scholar 

  23. Scott TL, Gazmararian JA, Williams MV, et al. Health literacy and preventive health care use among Medicare enrollees in a managed care organization. Med Care 2002; 40: 395–404

    Article  PubMed  Google Scholar 

  24. Health literacy: report of the Council on Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association. JAMA 1999; 281: 552–7

    Google Scholar 

  25. Baker DW, Williams MV, Parker RM, et al. Development of a brief test to measure functional health literacy. Patient Educ Couns 1999; 38: 33–42

    Article  PubMed  CAS  Google Scholar 

  26. Ruscin JM, Semla TP. Assessment of medication management skills in older outpatients. Ann Pharmacother 1996; 30: 1083–8

    PubMed  CAS  Google Scholar 

  27. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000; 160: 2101–7

    Article  PubMed  CAS  Google Scholar 

  28. Raehl CL, Bond CA, Woods T, et al. Individualized drug use assessment in the elderly. Pharmacotherapy 2002; 22: 1239–48

    Article  PubMed  Google Scholar 

  29. Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther 2001; 23: 1296–310

    Article  PubMed  CAS  Google Scholar 

  30. Christensen DB, Williams B, Goldberg HI, et al. Assessing compliance to antihypertensive medications using computerbased pharmacy records. Med Care 1997; 35: 1164–70

    Article  PubMed  CAS  Google Scholar 

  31. Eisen SA, Miller DK, Woodward RS, et al. The effect of prescribed daily dose frequency on patient medication compliance. Arch Intern Med 1990; 150: 1881–4

    Article  PubMed  CAS  Google Scholar 

  32. Cramer J, Vachon L, Desforges C, et al. Dose frequency and dose interval compliance with multiple antiepileptic medications during a controlled clinical trial. Epilepsia 1995; 36: 1111–7

    Article  PubMed  CAS  Google Scholar 

  33. Cramer JA, Mattson RH, Prevey ML, et al. How often is medication taken as prescribed? A novel assessment technique. JAMA 1989; 261: 3273–7

    Article  PubMed  CAS  Google Scholar 

  34. Taggart AJ, Johnston GD, McDevitt DG. Does the frequency of daily dosage influence compliance with digoxin therapy? Br J Clin Pharmacol 1981; 11: 31–4

    Article  PubMed  CAS  Google Scholar 

  35. Kruse W, Eggert-Kruse W, Rampmaier J, et al. Dosage frequency and drug-compliance behaviour: a comparative study on compliance with a medication to be taken twice or four times daily. Eur J Clin Pharmacol 1991; 41: 589–92

    Article  PubMed  CAS  Google Scholar 

  36. Tinkelman DG, Vanderpool GE, Carroll MS, et al. Compliance differences following administration of theophylline at six- and twelve-hour intervals. Ann Allergy 1980; 44: 283–6

    PubMed  CAS  Google Scholar 

  37. Pullar T, Birtwell AJ, Wiles PG, et al. Use of a pharmacologic indicator to compare compliance with tablets prescribed to be taken once, twice, or three times daily. Clin Pharmacol Ther 1988; 44: 540–5

    Article  PubMed  CAS  Google Scholar 

  38. Pushpangadan M, Feely M. Once a day is best: evidence or assumption? The relationship between compliance and dosage frequency in older people. Drugs Aging 1998; 13: 223–7

    Article  PubMed  CAS  Google Scholar 

  39. Greenberg RN. Overview of patient compliance with medication dosing: a literature review. Clin Ther 1984; 6: 593–9

    Google Scholar 

  40. Boissel JP, Nony P. Using pharmacokinetic-pharmacodynamic relationships to predict the effect of poor compliance. Clin Pharmacokinet 2002; 41: 1–6

    Article  PubMed  CAS  Google Scholar 

  41. Rudd P, Lenert L. Pharmacokinetics as an aid to optimising compliance with medications. Clin Pharmacokinet 1995; 28: 1–6

    Article  PubMed  CAS  Google Scholar 

  42. Burris JF, Papademetriou V, Wallin JD, et al. Therapeutic adherence in the elderly: transdermal clonidine compared to oral verapamil for hypertension. Am J Med 1991; 91: 22S–8S

    Article  PubMed  CAS  Google Scholar 

  43. de Klerk E. Patient compliance with enteric-coated weekly fluoxetine during continuation treatment of major depressive disorder. J Clin Psychiatry 2001; 62: 43–7

    PubMed  Google Scholar 

  44. Stewart RB. Noncompliance in the elderly: is there a cure? Drugs Aging 1991; 1: 163–7

    Article  PubMed  CAS  Google Scholar 

  45. Sharkness CM, Snow DA. The patient’s view of hypertension and compliance. Am J Prev Med 1992; 8: 141–6

    PubMed  CAS  Google Scholar 

  46. Lakshman M, Fernando M, Kazarian SS. Patient education in the drug treatment of psychiatric disorders. CNS Drugs 1995; 3: 291–304

    Article  Google Scholar 

  47. Stewart RB, Caranasos GJ. Medication compliance in the elderly. Med Clin North Am 1989; 73: 1551–63

    PubMed  CAS  Google Scholar 

  48. Lin IF, Spiga R, Fortsch W. Insight and adherence to medication in chronic schizophrenics. J Clin Psychiatry 1979; 40: 430–2

    PubMed  CAS  Google Scholar 

  49. Jackevicius CA, Mamdani M, Tu JV. Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA 2002; 288: 462–7

    Article  PubMed  Google Scholar 

  50. Meredith PA. Therapeutic implications of drug ‘holidays’. Eur Heart J 1996; 17Suppl. A: 21–4

    Article  PubMed  Google Scholar 

  51. Pullar T. Compliance with drug therapy. Br J Clin Pharmacol 1991; 32: 535–9

    Article  PubMed  CAS  Google Scholar 

  52. Cramer JA, Scheyer RD, Mattson RH. Compliance declines between clinic visits. Arch Intern Med 1990; 150: 1509–10

    Article  PubMed  CAS  Google Scholar 

  53. Feinstein AR. On white-coat effects and the electronic monitoring of compliance. Arch Intern Med 1990; 150: 1377–8

    Article  PubMed  CAS  Google Scholar 

  54. Garfield FB, Caro JJ. Achieving patient buy-in and long term compliance with antihypertensive treatment. Dis Manage Health Outcomes 2000; 7: 13–20

    Article  Google Scholar 

  55. Willey C, Redding C, Stafford J, et al. Stages of change for adherence with medication regimens for chronic disease: development and validation of a measure. Clin Ther 2000; 22: 858–71

    Article  PubMed  CAS  Google Scholar 

  56. Edelberg HK, Shallenberger E, Wei JY. Medication management capacity in highly functioning community-living older adults: detection of early deficits. Am Geriatr Soc 1999; 47: 592–6

    CAS  Google Scholar 

  57. Pullar T, Kumar S, Tindall H, et al. Time to stop counting the tablets? Clin Pharmacol Ther 1989; 46: 163–8

    Article  PubMed  CAS  Google Scholar 

  58. Rudd P, Byyny RL, Zachary V, et al. The natural history of medication compliance in a drug trial: limitations of pill counts. Clin Pharmacol Ther 1989; 46: 169–76

    Article  PubMed  CAS  Google Scholar 

  59. Paes AH, Bakker A, Soe-Agnie CJ. Measurement of patient compliance. Pharm World Sci 1998; 20: 73–7

    Article  PubMed  CAS  Google Scholar 

  60. Mojtabai R, Olfson M. Medication costs, adherence, and health outcomes among medicare beneficiaries. Health Affairs 2003; 22: 220–9

    Article  PubMed  Google Scholar 

  61. Paris W, Dunham S, Sebastian A, et al. Medication nonadherence and its relation to financial restriction. J Transpl Coord 1999; 9: 149–52

    PubMed  CAS  Google Scholar 

  62. Schoen MD, DiDomenico RJ, Connor SE, et al. Impact of the cost of prescription drugs on clinical outcomes in indigent patients with heart disease. Pharmacotherapy 2001; 21: 1455–63

    Article  PubMed  CAS  Google Scholar 

  63. Secnik K, Pathak DS, Cohen JM. Postcard and telephone reminders for unclaimed prescriptions: a comparative evaluation using survival analysis. J Am Pharm Assoc (Wash) 2000; 40: 243–51

    CAS  Google Scholar 

  64. Meyer ME, Schuna AA. Assessment of geriatric patients’ functional ability to take medication. DICP 1989; 23: 171–4

    PubMed  CAS  Google Scholar 

  65. Fitten LJ, Coleman L, Siembieda DW, et al. Assessment of capacity to comply with medication regimens in older patients. J Am Geriatr Soc 1995; 43: 361–7

    PubMed  CAS  Google Scholar 

  66. Edelberg HK, Shallenberger E, Wei JY. One-year follow-up of medication management capacity in highly functioning older adults. J Gerontol A Biol Sci Med Sci 2000; 55: M550–3

    Article  PubMed  CAS  Google Scholar 

  67. Hurd PD, Blevins J. Aging and the color of pills [letter]. N Engl J Med 1984; 310: 202

    PubMed  CAS  Google Scholar 

  68. Hurd PD, Butkovich SL. Compliance problems and the older patient: assessing functional limitations. Drug Intell Clin Pharm 1986; 20: 228–31

    PubMed  CAS  Google Scholar 

  69. Keram S, Williams ME. Quantifying the ease or difficulty older persons experience in opening medication containers. J Am Geriatr Soc 1988; 36: 198–201

    PubMed  CAS  Google Scholar 

  70. Morrell RW, Park DC, Poon LW. Quality of instructions on prescription drug labels: effects on memory and comprehension in young and old adults. Gerontologist 1989; 29: 345–54

    Article  PubMed  CAS  Google Scholar 

  71. Murray MD, Darnell J, Weinberger M, et al. Factors contributing to medication noncompliance in elderly public housing tenants. Drug Intell Clin Pharm 1986; 20: 146–52

    PubMed  CAS  Google Scholar 

  72. Morrell RW, Park DC, Poon LW. Effects of labeling techniques on memory and comprehension of prescription information in young and old adults. J Gerontol 1990; 45: P166–72

    Article  PubMed  CAS  Google Scholar 

  73. Hanchak NA, Patel MB, Berlin JA, et al. Patient misunderstanding of dosing instructions. J Gen Intern Med 1996; 11: 325–8

    Article  PubMed  CAS  Google Scholar 

  74. Isaac LM, Tamblyn RM. Compliance and cognitive function: a methodological approach to measuring unintentional errors in medication compliance in the elderly. McGill-Calgary Drug Research Team. Gerontologist 1993; 33: 772–81

    Article  PubMed  CAS  Google Scholar 

  75. Turner J, Wright E, Mendella L, et al. Predictors of patient adherence to long-term home nebulizer therapy for COPD. The IPPB Study Group. Intermittent Positive Pressure Breathing. Chest 1995; 108: 394–400

    Article  PubMed  CAS  Google Scholar 

  76. Gray SL, Williams DM, Pulliam CC, et al. Characteristics predicting incorrect metered-dose inhaler technique in older subjects. Arch Intern Med 1996; 156: 984–8

    Article  PubMed  CAS  Google Scholar 

  77. Partridge AH, Wang PS, Winer EP, et al. Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer. J Clin Oncol 2003; 21: 602–6

    Article  PubMed  CAS  Google Scholar 

  78. Roe CM, Motheral BR, Teitelbaum F, et al. Compliance with and dosing of angiotensin-converting-enzyme inhibitors before and after hospitalization. Am J Health Syst Pharm 2000; 57: 139–45

    PubMed  CAS  Google Scholar 

  79. Camus V, Kraehenbuhl H, Preisig M, et al. Geriatric depression and vascular diseases: what are the links? J Affect Disord 2004; 81(1): 1–16.

    Article  PubMed  Google Scholar 

  80. Wang PS, Bohn RL, Knight E, et al. Noncompliance with antihypertensive medications: the impact of depressive symptoms and psychosocial factors. J Gen Intern Med 2002; 17: 504–11

    Article  PubMed  Google Scholar 

  81. Ziegelstein RC, Bush DE, Fauerbach JA. Depression, adherence behavior, and coronary disease outcomes. Arch Intern Med 1998; 158: 808–9

    Article  PubMed  CAS  Google Scholar 

  82. Ciechanowski PS, Katon WJ, Russo JE. Depression and diabetes: impact of depressive symptoms on adherence, function, and costs. Arch Intern Med 2000; 160: 3278–85

    Article  PubMed  CAS  Google Scholar 

  83. Gurwitz JH, Yeomans SM, Glynn RJ, et al. Patient noncompliance in the managed care setting: the case of medical therapy for glaucoma. Med Care 1998; 36: 357–69

    Article  PubMed  CAS  Google Scholar 

  84. Rivers PH. Compliance aids: do they work? Drugs Aging 1992; 2: 103–11

    Article  PubMed  CAS  Google Scholar 

  85. Winfield AJ, Jessiman D, Williams A, et al. A study of the causes of non-compliance by patients prescribed eyedrops. Br J Ophthalmol 1990; 74: 477–80

    Article  PubMed  CAS  Google Scholar 

  86. Averns H, Hall J, Webley M. Role of opticare eye drop delivery system in patients with rheumatoid arthritis. J Rheumatol 1999; 26: 2615–8

    PubMed  CAS  Google Scholar 

  87. Easidrop. Easidrop: the ‘award winning’ eyedrop guide [online]. Available from URL: http://www.easidrop.com [Accessed 2003 Aug 22]

  88. American Family Medical. Owen Mumford Autodrop© eyedropper aid [online]. Available from URL: http://store.yahoo.com/americanfamily/owauteyaid.html [Accessed 2003 Aug 22]

  89. The Medical Supply Company Inc. Autodrop eyedropper aid [online]. Available from URL: http://www.medsupplyco.com/OWNOP6000.shtml [Accessed 2003 Aug 22]

  90. Owen Mumford. Autodrop [online]. Available from URL: http://www.owenmumford.com/brochure-ec.html#autodrop [Accessed 2003 Aug 22]

  91. Westons Internet. Opticare eye drop dispensers [online]. Available from URL: http://www.westons.com/prodhh33.htm [Accessed 2003 Aug 22 ]

  92. W+W Medsystems. Opticare & opticare arthro [online]. Available from URL: http://www.wwmed.co.uk/Cameron%20Graham%20Associates/opticare/index.htm [Accessed 2003 Aug 22]

  93. RNIB. Online shop: eye drop dispenser, opticare [online]. Available from URL: http://onlineshop.rnib.org.uk/display_product.asp?.prodid=938&status=2 [Accessed 2003 Aug 22]

  94. Girvin B, Johnston GD. The implications of noncompliance with antihypertensive medication. Drugs 1996; 52: 186–95

    Article  PubMed  CAS  Google Scholar 

  95. Struthers AD, MacFadyen R, Fraser C, et al. Nonadherence with angiotensin-converting enzyme inhibitor therapy: a comparison of different ways of measuring it in patients with chronic heart failure. J Am Coll Cardiol 1999; 34: 2072–7

    Article  PubMed  CAS  Google Scholar 

  96. BirdSong Medical Devices, Inc. The Doser [online]. Available from URL: http://birdsongmedical.net [Accessed 2003 Sep 15]

  97. E-Pill. CompuMed — E-pill medication reminders [online]. Available from URL: http://www.epill.com/compumed.html [Accessed 2005 Feb 14]

  98. E-Pill. Beep n’ tell — E-Pill medication reminders [online]. Available from URL: http://www.epill.com [Accessed 2003 Aug 22]

  99. E-Pill. HealthWatch & Windows PC software — E-Pill medication reminders [online]. Available from URL: http://www.epill.com [Accessed 2005 Feb 14]

  100. ResponseLink Inc. ResponseLink [online]. Available from URL: http://www.responselink.com [Accessed 2003 Aug 22]

  101. Lifeline Systems Inc. Lifeline [online]. Available from URL: http://www.lifelinesys.com [Accessed 2003 Aug 22]

  102. E-Pill. Kind Remind — E-Pill medication reminders [online]. Available from URL: http://www.epill.com [Accessed 2003 Aug 22]

  103. PTH Corporation. PTH LogPad [online]. Available from URL: http://www.phtcorp.com [Accessed 2003 Aug 22]

  104. Drugstore.com. MEDGlider pill case [online]. Available from URL: http://www.drugstore.com [Accessed 2005 Feb 14]

  105. Information Mediary Corporation. Med-ic digital package [online]. Available from URL: http://www.informationmediary.com/med-ic.htm [Accessed 2003 Aug 22]

  106. E-Pill. Med-Time — E-Pill medication reminders [online]. Available from URL: http://www.epill.com [Accessed 2003 Aug 22]

  107. Center for Internal Change. WatchMinder 01110 [online]. Available from URL: http://www.internalchange.com/watchminder/itmidx1.htm [Accessed 2005 Feb 14]

  108. Guthrie RM. The effects of postal and telephone reminders on compliance with pravastatin therapy in a national registry: results of the first myocardial infarction risk reduction program. Clin Ther 2001; 23: 970–80

    Article  PubMed  CAS  Google Scholar 

  109. Simkins CV, Wenzloff NJ. Evaluation of a computerized reminder system in the enhancement of patient medication refill compliance. Drug Intell Clin Pharm 1986; 20: 799–802

    PubMed  CAS  Google Scholar 

  110. Tavitian SM, Kidder PA, Shane R. Contacting patients with unclaimed prescriptions: the pharmacist’s impact on drug therapy concordance. Hosp Pharm 2001; 36: 1060–5

    Google Scholar 

  111. Ascione FJ, Brown GH, Kirking DM. Evaluation of a medication refill reminder system for a community pharmacy. Patient Educ Couns 1985; 7: 157–65

    Article  PubMed  CAS  Google Scholar 

  112. Bishop SK, Winckler SC. Implementing HIPAA privacy regulations in pharmacy practice. J Am Pharm Assoc (Wash) 2002; 42: 836–44

    Google Scholar 

  113. AARDEX Ltd. MEMS IV monitors [online]. Available from URL: http://www.aardexus.com/mems4mon2.htm [Accessed 2004 Mar 31]

  114. AARDEX Ltd. Advanced anlytical research on drug experience [online]. Available from URL: http://www.aardexus.com/default.htm [Accessed 2003 Aug 30]

  115. Choo PW, Rand CS, Inui TS, et al. Validation of patient reports, automated pharmacy records, and pill counts with electronic monitoring of adherence to antihypertensive therapy. Med Care 1999; 37: 846–57

    Article  PubMed  CAS  Google Scholar 

  116. Averbuch M, Weintraub M, Pollock DJ. Compliance assessment in clinical trials: the MEMS device. J Clin Res Pharmacoepidemiol 1990; 4: 199–204

    Google Scholar 

  117. Waterhouse DM, Calzone KA, Mele C, et al. Adherence to oral tamoxifen: a comparison of patient self-report, pill counts, and microelectronic monitoring. J Clin Oncol 1993; 11: 1189–97

    PubMed  CAS  Google Scholar 

  118. Burney KD, Krishnan K, Ruffin MT, et al. Adherence to single daily dose of aspirin in a chemoprevention trial: an evaluation of self-report and microelectronic monitoring. Arch Fam Med 1996; 5: 297–300

    Article  PubMed  CAS  Google Scholar 

  119. Straka RJ, Fish JT, Benson SR, et al. Patient self-reporting of compliance does not correspond with electronic monitoring: an evaluation using isosorbide dinitrate as a model drug. Pharmacotherapy 1997; 17: 126–32

    PubMed  CAS  Google Scholar 

  120. Kruse W, Weber E. Dynamics of drug regimen compliance: its assessment by microprocessor-based monitoring. Eur J Clin Pharmacol 1990; 38: 561–5

    Article  PubMed  CAS  Google Scholar 

  121. Matsuyama JR, Mason BJ, Jue SG. Pharmacists’ interventions using an electronic medication-event monitoring device’s adherence data versus pill counts. Ann Pharmacother 1993; 27: 851–5

    PubMed  CAS  Google Scholar 

  122. Wendel CS, Mohler MJ, Kroesen K, et al. Barriers to use of electronic adherence monitoring in an HIV clinic. Ann Pharmacother 2001; 35: 1010–5

    Article  PubMed  CAS  Google Scholar 

  123. Nides MA, Tashkin DP, Simmons MS, et al. Improving inhaler adherence in a clinical trial through the use of the nebulizer chronolog. Chest 1993; 104: 501–7

    Article  PubMed  CAS  Google Scholar 

  124. Julius SM, Sherman JM, Hendeles L. Accuracy of three electronic monitors for metered-dose inhalers. Chest 2002; 121: 871–6

    Article  PubMed  Google Scholar 

  125. Simmons MS, Nides MA, Rand CS, et al. Trends in compliance with bronchodilator inhaler use between follow-up visits in a clinical trial. Chest 1996; 109: 963–8

    Article  PubMed  CAS  Google Scholar 

  126. Winland-Brown JE, Valiante J. Effectiveness of different medication management approaches on elders’ medication adherence. Outcomes Manag Nurs Pract 2000; 4: 172–6

    PubMed  CAS  Google Scholar 

  127. Cherry JC, Moffatt TP, Rodriguez C, et al. Diabetes disease management program for an indigent population empowered by telemedicine technology. Diabetes Technol Ther 2002; 4: 783–91

    Article  PubMed  Google Scholar 

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  1. Department of Pharmacy Practice, Texas Tech University Health Sciences Center School of Pharmacy, Amarillo, Texas, USA

    Eric J. MacLaughlin,  Cynthia L. Raehl, Angela K. Treadway, Teresa L. Sterling & Chester A. Bond

  2. Department of Family Medicine, Texas Tech University Health Sciences Center School of Medicine, Amarillo, Texas, USA

    Eric J. MacLaughlin & Dennis P. Zoller

  3. Department of Psychiatry, Texas Tech University Health Sciences Center School of Medicine, Amarillo, Texas, USA

    Chester A. Bond

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  1. Eric J. MacLaughlin
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Correspondence to Cynthia L. Raehl.

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MacLaughlin, E.J., Raehl, C.L., Treadway, A.K. et al. Assessing Medication Adherence in the Elderly. Drugs Aging 22, 231–255 (2005). https://doi.org/10.2165/00002512-200522030-00005

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