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Roohi, Elnaz

University of British Columbia

Background: Patients with chronic kidney disease (CKD) are usually on multiple pharmacotherapies. It is crucial to properly understand and measure the levels of patients’ medication adherence due to negative health effects and economic burden of non-adherence. There is no gold standard tool for assessment of medication adherence in CKD patients and the extent of adherence among patients with CKD is poorly understood. Objective: The aim of this systematic review is to 1) Identify validated medication adherence measurement tools/methods that are used in clinical practice in the context of CKD patients. 2) Identify and synthesize key features of medication adherence methods and validated tools as an assessment of clinical applicability and feasibility in CKD patients. Methods: We systematically reviewed MEDLINE via Ovid, Embase via Ovid, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL (via EBSCO) from inception to August 08, 2023. All abstracts were screened by pairs of reviewers independently, followed by a full-text review identifying the tool/method used for measuring medication adherence. General study and medication adherence method/tool-specific characteristics were summarized. Results: The 32 articles which were included originated from 18 countries. The median of the sample size was 372.5 (3695), ranging from 31 to 559,865 with the age range varying between 14 and 76 years and an overall median age of 63.5 (15.5) years. Three (9.3%) studies were conducted on children and adolescents aged ≤18 years and the rest (n=29 [90.6%]) were conducted on adult patients aged ≥18 years. The most common measures used for evaluating medication adherence were Medication Possession Ratio (MPR) (n= 9 [28.1%]), Proportion of Days Covered (PDC) (n=8 [25%]), Eight-Item Morisky Medication Adherence Scale (MMAS-8) (n=5 [15.6%]), and Medication Events Monitoring System (MEMS) (n=5 [15.6%]). Five (15.6%) studies used more than one method to measure medication adherence. Conclusion: There is no accepted reference tool available to measure medication adherence in CKD patients. However, some tools were used with increased frequency in the context of patients with CKD. The choice of an appropriate method/tool or a combination of methods depends on the clinician/researcher’s goals, study setting, availability of data and other resources, and patients’ characteristics.

Text

2024-12-20

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/89958

Experimental Medicine

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/