CIRFF, Center of Pharmacoeconomics and Drug Utilization Research, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy.
Data Science Centre, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland.
Int J Environ Res Public Health. 2021 May 3;18(9):4872. doi: 10.3390/ijerph18094872.
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.
药物依从性是全球卫生系统的重点，并且被广泛认为是疾病管理护理质量的关键组成部分。与依从性相关的指标很少明确列入国家卫生政策议程。一个障碍是缺乏标准化的依从性术语和临床实践中常规的依从性测量方法。本文讨论了开发与依从性相关的绩效指标的可能性，强调了测量持久性作为护理质量的有力指标的价值。为了使依从性和持久性相关术语标准化，从而能够对依从性策略进行基准测试，欧洲确定依从性障碍（ABC）项目于 2012 年提出了一个依从性分类法，由三个部分组成：起始、实施、停药。在分类法中，紧随停药之前的持久性是一个关键要素，它可以捕捉依从性的时间顺序，从而可以检查药物使用行为的模式。电子卫生和信息通信技术（ICT）的进步可以在提供必要的结构以开发持久性指标方面发挥主要作用。我们建议将持久性作为衡量药物使用行为的信息性和务实措施。我们的观点是开发持久性的质量和绩效指标，这需要投资于 ICT 解决方案，使医疗保健提供者能够审查患者药物使用模式的完整信息以及临床和健康结果。
