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Measuring Medication Adherence Biological Assays. Pill Counts. Weight of Topical Medications. Electronic Monitoring. Pharmacy Records Prescription Claims. Patient Interviews. Patient Estimates of Adherence. Scaled Questionnaires.
The total score for each patient is calculated as the sum of the positive scores, minus the negative scores. A positive total score indicates a positive subjective response (adherent) and a negative total score indicates a negative subjective response (non-adherent).
Simply asking a patient how many pills he or she has left is a traditional, albeit imperfect, method of adherence monitoring. Random pill counts to assess overuse or diversion is a better objective measure of adherence and should be a stipulation in the controlled substance agreement.
The industry has adopted PDC as the gold standard for adherence because pharmacy fill data is widely available and can be measured easily.
The two most widely used approaches for calculating medication adherence are medication possession ratio (MPR) and proportion of days covered (PDC). The MPR is likely to overestimate adherence levels because the formula does not account for early refills.
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Methods to measure adherence Direct methods include direct observed therapy, measurement of the level of a drug or its metabolite in blood or urine and detection or measurement of a biological marker added to the drug formulation, in the blood.
The number of pills taken is calculated by subtracting the count of the number of pills remaining from the total number of pills dispensed. The drug adherence rate is then calculated by dividing the number of pills taken by number of days elapsed since the last dispense.

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