Jannah Wardatul, Khoiry Qisty A, Alfian Sofa D, Abdulah Rizky
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia.
Drug Utilization and Pharmacoepidemiology Research Group, Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia.
Patient Prefer Adherence. 2025 Jan 30;19:265-278. doi: 10.2147/PPA.S492461. eCollection 2025.
To identify the suitability of pharmacy-based measures for determining medication adherence in routine clinical use.
Data were obtained through PubMed and Scopus databases up to December 2023 without publication year restrictions. This review included English studies on assessing medication adherence for hypertension, hyperlipidemia, asthma, chronic obstructive pulmonary disease, and diabetes, using pharmacy databases and providing full-text access. We investigated evidence quality utilizing the Newcastle-Ottawa Scale for non-randomized studies (cohort, case-control, and cross-sectional) and the Risk of Bias Assessment Tool for Non-randomized Studies-2 and JADAD scales for quasi-experiments and randomized control trials, respectively. We determined validity characteristics (completeness, accuracy, reliability, objectivity, continuous adherence history, non-intrusiveness, sensitivity, and specificity) and applicability (cost-effectiveness, ease of use, and interpretability) to evaluate the suitability of pharmacy-based medication adherence measures in clinical settings.
This review retrieved 1513 studies, of which 74 met the inclusion criteria. All of the studies, which were published from 2000 to 2023 and mostly utilized a retrospective cohort design (n = 53), included 17.6 million patients. Of the 74 studies, 50 were conducted in the United States. Diabetes mellitus (n = 40) was the most prevalent disease, whereas the medication possession ratio (n = 46) and prescription days covered (n = 31) were the most prevalent pharmacy-based matrix. According to the results, 73 articles demonstrated validity characteristics, whereas 1 article lacked these characteristics. All 74 (100%) articles had applicability characteristics.
This systematic review demonstrates that pharmacy-based measures possess valid characteristics, including comprehensive, accurate, objective, reliable, and continuously updated adherence history records. These measures are designed to minimize disruption while offering high sensitivity and specificity. Furthermore, they are characterized by their practicality, being cost-effective, easy to implement, and easy to interpret. These findings suggest that pharmacy-based measures are potentially suitable to assess medication adherence for routine clinical use.
确定基于药房的措施在常规临床应用中用于确定药物依从性的适用性。
通过PubMed和Scopus数据库获取截至2023年12月的数据，无出版年份限制。本综述纳入了使用药房数据库并提供全文获取的、关于评估高血压、高脂血症、哮喘、慢性阻塞性肺疾病和糖尿病药物依从性的英文研究。我们分别使用纽卡斯尔-渥太华量表评估非随机研究（队列研究、病例对照研究和横断面研究）的证据质量，以及使用非随机研究偏倚风险评估工具-2和JADAD量表评估准实验和随机对照试验的证据质量。我们确定有效性特征（完整性、准确性、可靠性、客观性、连续依从性历史、非侵入性、敏感性和特异性）和适用性（成本效益、易用性和可解释性），以评估基于药房的药物依从性措施在临床环境中的适用性。
本综述检索到1513项研究，其中74项符合纳入标准。所有研究发表于2000年至2023年，大多采用回顾性队列设计（n = 53），共纳入1760万患者。在这74项研究中，50项在美国进行。糖尿病（n = 40）是最常见的疾病，而药物持有率（n = 46）和处方覆盖天数（n = 31）是最常见的基于药房的指标。根据结果，73篇文章展示了有效性特征，而1篇文章缺乏这些特征。所有74篇（100%）文章都具有适用性特征。
本系统综述表明，基于药房的措施具有有效的特征，包括全面、准确、客观、可靠且不断更新的依从性历史记录。这些措施旨在将干扰降至最低，同时具有高敏感性和特异性。此外，它们具有实用性，具有成本效益、易于实施且易于解释。这些发现表明，基于药房的措施可能适合在常规临床应用中评估药物依从性。
