METHODS OF MEASURING MEDICATION USE/COMPLIANCE IN THE COMMUNITY DWELLING POPULATION OF OLDER PEOPLE

Researchers across several decades have described patient compliance as “the best documented, but least understood health behavior” (Coons, 2001; Becker and Maiman, 1975). Although a variety of methods to measure compliance exist, problems with validity and reliability are inherent with every one of them (Marinker et al., 1997). Vik et al. (2004) state that presently there is no generally accepted gold standard for measuring adherence. This belief is highlighted by Steiner and Earnest (2000), who noted that the only way to be certain about a patient’s compliance is to administer the medication directly to the patient.

Seven methods of measuring compliance with medication regimes are described by the American Pharmacists Association (APhA, 2003):

• Clinical judgment
• Patient self report
• Clinical response
• Biochemical measures
• Pill counts
• Pharmacy records
• Electronic medication monitors

In the pages that follow, each method is briefly described, followed by a synthesis of current literature (where present) that has employed that method for community-dwelling older people.