Clinicians can combine technology with the perceptions of healthcare providers to help identify patients who skip medication doses, a study published in Pediatric Nephrology found.
The study, conducted by researchers from Baltimore-based Johns Hopkins Medicine, examined a population of young people with chronic kidney disease, but the findings can inform how clinicians can track nonadherence to medical recommendations more generally.
The researchers used technologies that provide more objective measures of whether patients are following their medication regimen, including EMRs connected to pharmacy data and electronic pill boxes that record when they're opened.
To see when patients were skipping medication, the researchers used five measures of nonadherence in 87 adolescents and young adults with chronic kidney disease or end-stage renal disease. All patients were seeing one of 17 participating medical providers at one of three academic medical centers.
The measures of adherence were provider reports (healthcare provider's estimation of a patient's medication adherence), patient reports, caregiver reports, electronic pill boxes and pharmacy refill data.
Although healthcare providers and electronic pillboxes both classified 34.5 percent of patients as nonadherent, they disagreed about which patients were nonadherent, the researchers found. Patient reports, caregiver reports and pharmacy refill data all classified between 50 percent and 61 percent of patients as nonadherent.
Combining provider reports with the pharmacy refill data was more effective at identifying patients who don't take their pills, the researchers found.
"In general, providers are already doing assessments of patients' adherence levels, and most clinical practices have the ability to access pharmacy refill data, so this is a very feasible thing to start doing in a clinical setting," said first author Cozumel Pruette, MD.