Evidence map›Paper›PMID 23774515›Full record

ArticleMedical care2013

Standardizing terminology and definitions of medication adherence and persistence in research employing electronic databases.

Marsha A Raebel, Julie Schmittdiel, Andrew J Karter, Jennifer L Konieczny, John F Steiner

3 registry-linked trialsOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Medical care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 261 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
261citing papers in PubMed, 11 pooled it
9.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02621476 nacompletednot on this mapstarted 2017, after this paper: background citation

Encouraging Mail Order Pharmacy Use to Improve Outcomes and Reduce Disparities

TypeinterventionalSponsorKaiser PermanenteRan2017 to 2022Enrolled63,012ConditionsDiabetes MellitusArmsStandardized intervention, Usual care
NCT05072275 unknown statusnot on this mapstarted 2023, after this paper: background citation

Prospective Electronic Polygenic Risk Study (PEPRS) - First Phase

TypeobservationalSponsorScripps Translational Science InstituteRan2023 to 2023Enrolled1,000ConditionsCoronary Artery Disease
NCT05175651 nanot yet recruitingnot on this mapstarted 2023, after this paper: background citation

Prospective Electronic Polygenic Risk Study - Second Phase

TypeinterventionalSponsorScripps Translational Science InstituteRan2023 to 2027Enrolled10,000ConditionsCoronary Artery Disease, GlaucomaArmsGenetic risk assessment
3 · Its place in the literature

Who cites it

261 citing papers in PubMed, 11 syntheses or guidelines pooled it, 478 citations in OpenAlex.

  1. Patient-Provider Race Concordance and Medication Adherence: A Systematic Review.Journal of racial and ethnic health disparities · 2026
    Pooled it
  2. Pooled it
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  4. Methods to assess COPD medications adherence in healthcare databases: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2023
    Pooled it
  5. Pooled it
  6. Pooled it
  7. Medication adherence with fixed-doseFrontiers in pharmacology · 2023
    Pooled it
  8. Pooled it
  9. Pooled it
  10. Guideline
  11. Pooled it
  12. Trial
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  17. Article
  18. The consequences of medicine shortages on healthcare utilization and care fragmentation.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
    Article
  19. Article
  20. Review

201 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Marsha A RaebelKaiser Permanente Colorado Institute for Health Research, Denver, CO 80231, USA. marsha.a.raebel@kp.org
Julie Schmittdiel
Andrew J Karter
Jennifer L Konieczny
John F Steiner
Kaiser Permanente · USUniversity of Colorado Anschutz Medical Campus · USUniversity of Montana · US

Funding

Medication Adherence and Social Disparities in DiabetesR01DK080726 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI KARTER, ANDREW JOHN · 2009 to 2012
$1.5M
NIDDK NIH HHS R01 DK080726
6 · The paper itself

Abstract

objectiveTo propose a unifying set of definitions for prescription adherence research utilizing electronic health record prescribing databases, prescription dispensing databases, and pharmacy claims databases and to provide a conceptual framework to operationalize these definitions consistently across studies.

methodsWe reviewed recent literature to identify definitions in electronic database studies of prescription-filling patterns for chronic oral medications. We then develop a conceptual model and propose standardized terminology and definitions to describe prescription-filling behavior from electronic databases.

resultsThe conceptual model we propose defines 2 separate constructs: medication adherence and persistence. We define primary and secondary adherence as distinct subtypes of adherence. Metrics for estimating secondary adherence are discussed and critiqued, including a newer metric (New Prescription Medication Gap measure) that enables estimation of both primary and secondary adherence. DISCUSSION: Terminology currently used in prescription adherence research employing electronic databases lacks consistency. We propose a clear, consistent, broadly applicable conceptual model and terminology for such studies. The model and definitions facilitate research utilizing electronic medication prescribing, dispensing, and/or claims databases and encompasses the entire continuum of prescription-filling behavior.

conclusionEmploying conceptually clear and consistent terminology to define medication adherence and persistence will facilitate future comparative effectiveness research and meta-analytic studies that utilize electronic prescription and dispensing records.

Indexed as

Drug MonitoringTerminology as TopicDatabases, FactualElectronic Health RecordsHealth Services ResearchHumansInsurance Claim ReviewMulticenter Studies as TopicPharmaceutical Services

Identifiers

PMID23774515
PMCPMC3727405
OpenAlexW2014390724

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.