Objective method for measuring adherence- pillcounting and medical dispensers

Question 1

Name 3 objective methods to measure adherence?

Answer 1

1. Medical dispensers.
2. Pill counting
3. Electrical mesuring devices/ dispensers (e.g Trackcap/ AdhereTech)

EMD

Question 2

What are medical dispensers?

Answer 2

Medical devices which organise and store medication tablets- they require patients to place the correct tablets in specific compartments (typically days of week)

Question 3

Medical dispensers (simple definition)

Answer 3

• Devices that store and organise medication tablets.

Question 4

Name 1 strength and 1 weakness of using medical dispensers to measure adherence?

Answer 4

Strength (objective)- provides objective, quantitative data on the amount of pills consumed- thus unreliant on subjective measures/patient honesty.
Weakness (manipulation risks/ validity)- cannot confirm whether tablets were actually consumed- only shows if pills were removed. Patients may disgard pills to appear adherent. No timed data- cannot confirm whether doses where taken at correct intervals.

Question 5

What is pill counting?

Answer 5

Involves practioners comparing the remaining pills in a patient’s medication bottle to the expectected perscribed usage.

Question 6

Name 1 strength and 1 weakness of using pill counting to measure adherence?

Answer 6

• Strength (effiecient/ easy) Very quick method to measure adherence levels- just requires a quick count of remaining medicine (clinical utility/ suitable for wide-scale use)
  Weakness (manipulation risks/ validity)- cannot confirm whether tablets were actually consumed- only shows if pills were removed. Patients may disgard pills to appear adherent. No timed data- cannot confirm whether doses where taken at correct intervals.

Question 7

What are electronic medication dispensers/ moniors?

Answer 7

A digital smart device that automatically dispenses medication at pre-set times, records adherence data (timestamps, missed doses), provides alterts to remind patients (sounds, lights etc).

Question 8

Name 1 strength and 1 weakness of using electronic medication dispensers/ monitors?

Answer 8

• Strength (high validity/objective)- provides realtime monitoring with time-stamps of bottle openings/ pill removals. Mitigates recall bias (unreliant on patient memory). Can provide behavioural insights (e.g. patient keeps skipping doses on weekend).
• Weakness (cost/ accessibility)- expensive for large-scale use, may not be covered by insurers. Ethics- continous monitoring may feel intrusive.