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Standardizing Terminology and Definitions of Medication Adherence and Persistence in Research Employing Electronic Databases
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Standardizing Terminology and Definitions of Medication Adherence and Persistence in Research Employing Electronic Databases
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Journal Article
Standardizing Terminology and Definitions of Medication Adherence and Persistence in Research Employing Electronic Databases
2013
Overview
Objective: To propose a unifying set of definitions for prescription adherence research utilizing electronic health record prescribing databases, prescription dispensing databases, and pharmacy claims databases and to provide a conceptual framework to operationalize these definitions consistently across studies. Methods: We reviewed recent literature to identify definitions in electronic database studies of prescription-filling patterns for chronic oral medications. We then develop a conceptual model and propose standardized terminology and definitions to describe prescription-filling behavior from electronic databases. Results: The conceptual model we propose defines 2 separate constructs: medication adherence and persistence. We define primary and secondary adherence as distinct subtypes of adherence. Metrics for estimating secondary adherence are discussed and critiqued, including a newer metric (New Prescription Medication Gap measure) that enables estimation of both primary and secondary adherence. Discussion: Terminology currently used in prescription adherence research employing electronic databases lacks consistency. We propose a. clear, consistent, broadly applicable conceptual model and terminology for such studies. The model and definitions facilitate research utilizing electronic medication prescribing, dispensing, and/or claims databases and encompasses the entire continuum of prescription-filling behavior. Conclusion: Employing conceptually clear and consistent terminology to define medication adherence and persistence will facilitate future comparative effectiveness research and meta-analytic studies that utilize electronic prescription and dispensing records.
Publisher
Lippincott Williams & Wilkins,by Lippincott Williams & Wilkins,Lippincott Williams & Wilkins Ovid Technologies
Subject
/ Databases, Factual - statistics & numerical data
/ Drugs
/ Electronic Health Records - organization & administration
/ Electronic Health Records - statistics & numerical data
/ Humans
/ Insurance Claim Review - statistics & numerical data
/ Medication Adherence - statistics & numerical data
/ Multicenter Studies as Topic - statistics & numerical data
/ Pharmaceutical Services - statistics & numerical data
/ Ratios
