ArticleBMJ open diabetes research & care2016
The agreement of patient-reported versus observed medication adherence in type 2 diabetes mellitus (T2DM).
Article in BMJ open diabetes research & care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Quality of measurement properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: a systematic review and meta-analysis.Systematic reviews · 2023Pooled it
- Trial
- Review
- Medication Adherence in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation.Cancers · 2025Article
- The Association Between Patient-reported Clinical Factors and 30-day Acute Care Utilization in Chronic Heart Failure.Medical care · 2020Article
- Medication Management Performance and Associated Cognitive Correlates in Healthy Older Adults and Older Adults with aMCI.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2019Article
- The Effect of Age and Comorbidities on the Association Between the Medicare STAR Oral Antihyperglycemic Adherence Metric and Glycemic Control.Journal of managed care & specialty pharmacy · 2018Observational
- Sensitivity of the Medication Possession Ratio to Modelling Decisions in Large Claims Databases.PharmacoEconomics · 2018Article
- Illustrating Informed Presence Bias in Electronic Health Records Data: How Patient Interactions with a Health System Can Impact Inference.EGEMS (Washington, DC) · 2017Article
- Treatment adherence and perception in patients on maintenance hemodialysis: a cross - sectional study from Palestine.BMC nephrology · 2017Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
objectiveMedication adherence in type 2 diabetes mellitus (T2DM) improves glycemic control and is associated with reduced adverse clinical events, and accurately assessing adherence assessment is important. We aimed to determine agreement between two commonly used adherence measures-the self-reported Morisky Medication Adherence Scale (MMAS) and direct observation of medication use by nurse practitioners (NPs) during home visits-and determine the relationship between each measure and glycated hemoglobin (HbA1c). RESEARCH DESIGN AND
methodsWe evaluated agreement between adherence measures in the Southeastern Diabetes Initiative (SEDI) prospective clinical intervention home visit cohort, which included high-risk patients (n=430) in 4 SEDI-participating counties. The mean age was 58.7 (SD 11.6) years. The majority were white (n=210, 48.8%), female (n=236, 54.9%), living with a partner (n=316, 74.5%), and insured by Medicare/Medicaid (n=361, 84.0%). Medication adherence was dichotomized to 'adherent' or 'not adherent' using established cut-points. Inter-rater agreement was evaluated using Cohen's κ coefficient. Relationships among adherence measures and HbA1c were evaluated using the Wilcoxon rank-sum test and c-statistics.
resultsFewer patients (n=261, 61%) were considered adherent by self-reported MMAS score versus the NP-observed score (n=338; 79%). Inter-rater agreement between the two adherence measures was fair (κ=0.24; 95% CI 0.15 to 0.33; p<0.0001). Higher adherence was significantly associated with lower HbA1c levels for both measures, yet discrimination was weak (c-statistic=0.6).
conclusionsAgreement between self-reported versus directly observed medication adherence was lower than expected. Though scores for both adherence measures were significantly associated with HbA1c, neither discriminated well for discrete levels of HbA1c.
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