Developing a core outcome set for evaluating medication adherence interventions for adults prescribed long-term medication in primary care

Debi Bhattacharya; Kumud Kantilal; Jacqueline Martin-Kerry; Vanessa Millar; Allan Clark; David Wright; Katherine Murphy; David Turner; Sion Scott

doi:10.1016/j.sapharm.2024.04.002

Developing a core outcome set for evaluating medication adherence interventions for adults prescribed long-term medication in primary care

Res Social Adm Pharm. 2024 Apr 3:S1551-7411(24)00116-5. doi: 10.1016/j.sapharm.2024.04.002. Online ahead of print.

Authors

Debi Bhattacharya¹, Kumud Kantilal², Jacqueline Martin-Kerry², Vanessa Millar², Allan Clark³, David Wright⁴, Katherine Murphy², David Turner³, Sion Scott²

Affiliations

¹ School of Healthcare, University of Leicester, Leicester, UK. Electronic address: d.bhattacharya@leicester.ac.uk.
² School of Healthcare, University of Leicester, Leicester, UK.
³ Norwich Medical School, University of East Anglia, Norwich, UK.
⁴ School of Healthcare, University of Leicester, Leicester, UK / School of Pharmacy, University of Bergen, Bergen, Norway.

PMID: 38614842
DOI: 10.1016/j.sapharm.2024.04.002

Abstract

Background: Approximately half of people prescribed medications do not take them as prescribed. There is a significant unmet need regarding the barriers to medication adherence not being addressed in primary care. There is no agreement on which outcomes should be measured and reported in trials of medication adherence interventions.

Objective: To develop a core outcome set (COS) for trials of medication adherence interventions in primary care for adults prescribed medications for long-term health conditions.

Methods: A list of potentially relevant outcomes from the literature was developed. Using a two-round Delphi survey of stakeholder groups representing patients and their carers; primary care staff; and academic researchers with an interest in medication adherence; each outcome was scored in terms of importance for determining the effectiveness of medication adherence interventions in primary care. This was followed by two consensus workshops, where importance, as well as feasibility and acceptability of measurement, were considered in order to finalise the COS.

Results: One hundred and fifty people took part in Delphi Round 1 and 101 took part in Round 2. Eight people attended the workshops (four attendees per workshop). Seven outcomes were identified as most important, feasible and acceptable to collect in medication adherence trials: Health-related quality of life, number of doses taken, persistence with medicines, starting (initiating) a medicine, relevance of the medication adherence intervention for an individual, mortality, and adverse medicine events.

Conclusions: This COS represents the minimum outcomes that should be collected and reported in all medication adherence trials undertaken in primary care. When developing and finalizing the COS, feasibility and acceptability of collection of outcomes has been considered. In addition to the COS, medication adherence trials can choose to include outcomes to suit their specific context such as the health condition associated with their medication adherence intervention.

Keywords: Adults; Compliance; Delphi; Long-term conditions; Primary care; Workshops.