title: Validity of electronically monitored medication adherence and conventional adherence measures in schizophrenia.
abstract: OBJECTIVE
  This study evaluated the validity of prescriber, patient, and research assistant ratings of adherence to prescribed oral antipsychotic medication among outpatients with schizophrenia or schizoaffective disorder in comparison with electronic monitoring.
  
  
  METHODS
  Adult outpatients with schizophrenia (N=35) or schizoaffective disorder (N=26) received adherence assessments via electronically monitored medication vial caps as well as by monthly prescriber, patient, and research assistant report for up to six months.
  
  
  RESULTS
  Electronic monitoring detected greater nonadherence rates (57%) than either prescribers (7%) or patients (5%), though the research assistant ratings were 54%. No directional bias was found between electronic monitoring and assignment of adherence by research assistants, although disagreement occurred in 36% of cases.
  
  
  CONCLUSIONS
  Both patients and prescribers grossly overestimated medication adherence, which may interfere with or reduce the effectiveness of diligent medication management.
authors.affiliation: Department of Psychiatry, University of Texas Southwestern Medical Center 6363 Forest Park Rd., Suite 651, Dallas, TX 75235-8828, USA. matt.byerly@utsouthwestern.edu
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Byerly
authors.forename: Ann
authors.initials: A
authors.lastname: Thompson
authors.forename: Thomas
authors.initials: T
authors.lastname: Carmody
authors.forename: Rhiannon
authors.initials: R
authors.lastname: Bugno
authors.forename: Thomas
authors.initials: T
authors.lastname: Erwin
authors.forename: Michael
authors.initials: M
authors.lastname: Kashner
authors.forename: A John
authors.initials: AJ
authors.lastname: Rush
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015982:Bias; D003625:Data Collection / Q000706:statistics & numerical data*; D016903:Drug Monitoring; D004349:Drug Packaging; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012650:Self Disclosure
chemical_list: D014150:Antipsychotic Agents