An overview of the common methods used to measure treatment adherence
Open accessAbstract
Background and aims. The success of a treatment depends on the effectiveness of the medication regimen, provided that patients take the medicines as prescribed. A low rate of adherence in chronic conditions is associated with poor outcome and decreased quality of life, which constitutes an additional burden for the healthcare systems. To correctly identify the dimension of this problem may be a challenge, as there are numerous methods, definitions, patient settings and factors, each with their specific roles. Our aim was to give an appropriate overview of the most common validated methods that can be used to identify non-adherent patients. Methods. This overview is based on an online search of PubMed database and includes the relevant articles in this field. Results. We included both direct and indirect methods for measuring treatment adherence and presented concise information that can help researchers and clinicians when choosing an appropriate method. Both subjective and objective methods have advantages and disadvantages that should be fully understood and taken into consideration. Conclusions. Choosing a simple, accurate and inexpensive method that can give supplementary information about the patterns, beliefs and barriers of adherence would be desirable. But because this perfect method to measure treatment adherence does not exist, the best solution seems to be the combined use of at least two methods.
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Self-reported adherence is simple and cost-effective but prone to recall and social desirability bias.
“Self-reported adherence is simple and cost-effective but prone to recall and social desirability bias.130,131,133,134”
From Adherence to PCSK9 Inhibitors in Clinical Practice (2026) · cites this paper as [130]
The Discussion’s ‘Indirect methods’ section describes self-reported methods as cheap and simple and says recall or reporting bias can lead them to overestimate adherence. It does not specifically identify social desirability as the source of reporting bias, so that more specific part of the claim is not established by our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measuredPersistence measures derived from databases such as claims data cannot confirm actual medication use and may misclassify patients who switch insurers as nonadherent.
“Persistence measures derived from databases, such as claims data, cannot confirm actual medication use and may misclassify patients who switch insurers as nonadherent.130,131,134”
From Adherence to PCSK9 Inhibitors in Clinical Practice (2026) · cites this paper as [130]
The Discussion > Indirect methods passage says that pharmacy and insurance claims data measure medication possession, not actual intake, supporting the first part of the claim. It does not discuss patients switching insurers or being misclassified as nonadherent for that reason (no page number is available in our copy). (LLM, conf=0.88)
Experimental — accuracy not yet measuredRefill records may attribute treatment gaps to patients even when discontinuation was clinician-directed.
“Additionally, refill records may attribute treatment gaps to patients, even when discontinuation was clinician-directed.130,131,134”
From Adherence to PCSK9 Inhibitors in Clinical Practice (2026) · cites this paper as [130]
The Discussion (Indirect methods; page not supplied) says refill records assume refilling reflects medication-taking and provide little information about reasons for non-adherence. The Background (page not supplied) notes that healthcare providers can influence medicine-taking, but the paper does not specifically say that refill gaps may be attributed to patients when a clinician directed discontinuation. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThere is no universally accepted gold standard for measuring medication adherence.
“Currently, there is no universally accepted gold standard for measuring medication adherence, as all existing methods have inherent strengths and limitations.130, 131, 132”
From Adherence to PCSK9 Inhibitors in Clinical Practice (2026) · cites this paper as [130]
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Cites
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Cited by
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Adherence to PCSK9 Inhibitors in Clinical Practice
Blais, J. E., Zhong, W., Li, C. Y. V., Kongkaew, C., & Chan, A. H. Y. (2026) · JACC: Advances · doi:10.1016/j.jacadv.2026.102733 · Cited by 7 · see citing works
- Authors
- Anghel, L. A., Farcas, A. M., & Oprean, R. N.
- Affiliations
- Iuliu Hațieganu University of Medicine and Pharmacy (RO)
- Corresponding author
- Anghel, Laura Alexandra
- Venue
- Medicine and Pharmacy Reports
- Publisher
- Clujul Medical
- Published
- 2019-04-22
- Volume
- 92
- Issue
- 2
- Pages
- 117-122
- ISSN
- 2602-0807 (ISSN-L)
- 2668-0572
- PMC
- PMC6510353
- OpenAlex
- W2941690445
- Cited by
- 335
- References
- 6
- Citations by year
- 2026: 30 · 2025: 62 · 2024: 71 · 2023: 55 · 2022: 58 · 2021: 43 · 2020: 16
- FWCI
- 7.43
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Medicine and Pharmacy Reports (publishedVersion, cc-by-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Keywords
- medication adherence, medication adherence measurement, adherence assessment methods, chronic disease, barriers to adherence, medication beliefs
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