Skip to main content

Advertisement

Log in

Use of Electronic Monitoring Devices to Measure Antiretroviral Adherence: Practical Considerations

  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The purpose of this paper is to describe electronic monitoring device (EMD) (e.g., MEMS caps) use among HIV-infected adults enrolled in a randomized clinical trial and to make explicit some of the benefits and caveats of using electronic monitoring device technology. This is a descriptive, exploratory study of EMD use among 128 HIV-infected adults treated with at least three antiretroviral agents. Thirty-six percent of the sample admitted that they did not use the EMD consistently. Forty-one percent of the subjects reported taking out more than one dose at a time and 26% reported opening the EMD but not taking the medication. Special subject-related issues accounted for only a small percentage of all reported problems with EMD use (e.g., transient housing, incarceration, substance abuse relapse and drug treatment). Results of this study suggest that EMDs may underestimate antiretroviral adherence among HIV-infected adults. Recommendations for improving EMD data quality are presented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bangsberg, D. R., Hecht, F. M., Charlebois, E. D., Chesney, M., and Moss, A. (2001). Comparing objective measures of adherence to HIV antiretroviral therapy: Electronic medication monitors and unannounced pill counts. AIDS and Behavior, 5, 275–281.

    Google Scholar 

  • Bangsberg, D. R., Hecht F. M., Charlebois, E. D., Zolopa, A. R., Holodniy, M., Sheiner, L., Bamberger, J. D., Chesney, M. A., and Moss, A. (2000). Adherence to protease inhibitors, HIV-1 viral load and development of drug resistance in an indigent population. AIDS, 14, 357–366.

    PubMed  CAS  Google Scholar 

  • Burney, K. D., Krishnan, K., Ruffin, M. T., Zhang, D., and Brenner, D. E. (1996). Adherence to single daily dose of aspirin in a chemoprevention trial: An evaluation of self-report and microelectronic monitoring. Archives of Family Medicine, 5, 297–300.

    PubMed  CAS  Google Scholar 

  • Cramer, J. A., Mattson, R. H., Prevey, M. L., Scheyer, R. D., and Ouellette, V. L. (1989). How often is medication taken as prescribed? A novel assessment technique. JAMS, 261, 3273–3277.

    CAS  Google Scholar 

  • Cramer, J. A., Scheyer, R. D., and Mattson, R. H. (1990). Compliance declines between clinic visits. Archives of Internal Medicine, 150, 1377–1378.

    Google Scholar 

  • Dunbar-Jacob, J., Erlen, J. A., Schlenk, E. A., Ryan, C. M., Sereika, S. M., and Doswell, W. M. (2000). Adherence in Chronic Disease. Annual Review of Nursing Research, 18, 48–90.

    PubMed  CAS  Google Scholar 

  • Farmer, K. C. (1999). Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clinical Therapeutics, 21, 1074–1090.

    PubMed  CAS  Google Scholar 

  • Frick, P. A., Gal, P., Lane, T. W., and Sewell, P. C. (1998). Antiretroviral medication compliance in patients with AIDS. AIDS Patient Care and STDs, 12, 463–470.

    Article  PubMed  CAS  Google Scholar 

  • Jonsson, E. N., Wade, J. R., Almqvist, G., and Karlsson, M. O. (1997). Discrimination between rival dosing histories. Pharmaceutical Research, 14, 984–991.

    PubMed  CAS  Google Scholar 

  • Liu, H., Golin, C. E., Miller, L. G., Hays, R. D., Beck, C. K., Sanandaji, S., Christian, J., Maldonado, T., Duran, D., Kaplan, A. H., and Wenger, N. S. (2001). A comparison study of multiple measures of adherence to HIV protease inhibitors. Annals of Internal Medicine, 134, 968–977.

    PubMed  CAS  Google Scholar 

  • Lyketsos, C. G., Hoover, D. R., Guccione, M., Dew, M. A., Wesch, J. E., Bing, E. G., and Treisman, G. L. (1996). Changes in depressive symptoms as AIDS develops. American Journal of Psychiatry, 153, 1430–1437.

    PubMed  CAS  Google Scholar 

  • Matsui, D., Hermann, C., Klein, J., Berkovitch, M., Olivieri, N., and Koren, G. (1994). Critical comparison of novel and existing methods of compliance assessment during a clinical trial of an oral iron chelator. Journal of Clinical Pharmacology, 34, 944–949.

    PubMed  CAS  Google Scholar 

  • McClure, J. B., Catz, S. L., Prejean, J., Brantley, P. J., and Jones, G. N. (1996). Factors associated with depression in a heterogeneous HIV-infected sample. Journal of Psychosomatic Research, 40, 407–415.

    PubMed  CAS  Google Scholar 

  • Miller, L. G., Liu, H., Hays, R. D., Golin, C. E., Beck, C. K., Asch, S. M., Ma, Y., Kaplan, A. H., and Wenger, N. S. (2002). How well do clinicians estimate patients’ adherence to combination antiretroviral therapy? Journal of General Internal Medicine, 17, 1–11.

    PubMed  Google Scholar 

  • Olivieri, N., Matsui, D., Hermann, C., and Koren, G. (1991). Compliance assessed by the medication event monitoring system. Archives of Disease in Childhood, 66, 1399–1402.

    Article  PubMed  CAS  Google Scholar 

  • Paes, A. H., Bakker, A., and Soe-Agnie, C. J. (1998). Measurement of patient compliance. Pharmacy World & Science, 20, 73–77.

    CAS  Google Scholar 

  • Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

    Google Scholar 

  • Samet, J. H., Sullivan, L. M., Traphagen, E. T., and Ickovics, J. R. (2001). Measuring adherence among HIV-infected persons: Is MEMS consummate technology? AIDS and Behavior, 5, 21–29.

    Google Scholar 

  • Schwed, A., Fallab, C. L., Burnier, M., Waeber, B., Kappenberger, L., Burnand, B., and Darioli, R. (1999). Electronic monitoring of compliance to lipid-lowering therapy in clinical practice. Journal of Clinical Pharmacology, 39, 402–409.

    PubMed  CAS  Google Scholar 

  • Sereika, S. M., and Dunbar-Jacob, J. (2000). Analysis of electronic event monitored adherence. In L. Burke and I. Ockene (Eds.), Compliance in healthcare research (pp. 139–162). Armonk, NY: Futurea Publishing.

    Google Scholar 

  • Spilker, B. (1991). Methods of assessing and improving patient compliance in clinical trials. In J. A. Cramer and B. Spilker (Eds.), Patient compliance in medical practice and clinical trials (pp. 37–56). New York: Raven Press.

    Google Scholar 

  • Straka, R. J., Fish, J. T., Benson, S. R., and Suh, J. T. (1997). Patient self-reporting of compliance does not correspond with electronic monitoring: An evaluation using isosorbide dinitrate as a model drug. Pharmacotherapy, 17, 126–132.

    PubMed  CAS  Google Scholar 

  • Turner, B. J., and Hecht, F. M. (2001). Improving on a coin toss to predict patient adherence to medications. Annals of Internal Medicine, 134, 1004–1006.

    PubMed  CAS  Google Scholar 

  • Wagner, G. J., and Rabkin, J. G. (2000). Measuring medication adherence: Are missed doses reported more accurately then perfect adherence? AIDS Care, 12, 405–408.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carol A. Bova PhD, RN, ANP.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bova, C.A., Fennie, K.P., Knafl, G.J. et al. Use of Electronic Monitoring Devices to Measure Antiretroviral Adherence: Practical Considerations. AIDS Behav 9, 103–110 (2005). https://doi.org/10.1007/s10461-005-1685-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-005-1685-0

Keywords

Navigation