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

Enrica Menditto, Caitriona Cahir, Sara Malo, Isabel Aguilar-Palacio, Marta Almada, Elisio Costa, Anna Giardini, María Gil Peinado, Mireia Massot Mesquida, Sara Mucherino, Valentina Orlando, Carlos Luis Parra-Calderón, Enrique Pepiol Salom, Przemyslaw Kardas and Bernard Vrijens
Additional contact information
Enrica Menditto: CIRFF, Center of Pharmacoeconomics and Drug Utilization Research, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
Caitriona Cahir: Data Science Centre, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland
Sara Malo: Preventive Medicine and Public Health Department, Zaragoza University, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
Isabel Aguilar-Palacio: Preventive Medicine and Public Health Department, Zaragoza University, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
Marta Almada: UCIBIO/REQUIMTE, Competences Centre on Active and Healthy Ageing of the University of Porto, Porto4Ageing, Faculty of Pharmacy, University of Porto, 4099-002 Porto, Portugal
Elisio Costa: UCIBIO/REQUIMTE, Competences Centre on Active and Healthy Ageing of the University of Porto, Porto4Ageing, Faculty of Pharmacy, University of Porto, 4099-002 Porto, Portugal
Anna Giardini: IT Department, Istituti Clinici Scientifici Maugeri IRCCS Pavia, Pavia 27100, Italy
María Gil Peinado: Drug Information Centre and Pharmaceutical Care Department, Muy Ilustre Colegio Oficial de Farmacéuticos de Valencia (MICOF Valencia), 46003 Valencia, Spain
Mireia Massot Mesquida: Servei d’Atenció Primària Vallès Occidental, Institut Català de la Salut, 08202 Barcelona, Spain
Sara Mucherino: CIRFF, Center of Pharmacoeconomics and Drug Utilization Research, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
Valentina Orlando: CIRFF, Center of Pharmacoeconomics and Drug Utilization Research, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
Carlos Luis Parra-Calderón: Group of Research and Innovation in Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville, IBiS/Virgen del Rocío University Hospital/CSIC/University of Seville, 41004 Sevilla, Spain
Enrique Pepiol Salom: International Committee, Muy Ilustre Colegio Oficial de Farmacéuticos de Valencia (MICOF Valencia), 46003 Valencia, Spain
Przemyslaw Kardas: Medication Adherence Research Centre, Medical University of Lodz, 90-136 Lodz, Poland
Bernard Vrijens: AARDEX Group & Liège University, 4000 Liège, Belgium

IJERPH, 2021, vol. 18, issue 9, 1-9

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: medication adherence; persistence; quality of care; performance indicator; electronic health records (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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