title: Monitoring medication adherence by unannounced pill counts conducted by telephone: reliability and criterion-related validity.
abstract: BACKGROUND
  Although demonstrated valid for monitoring medication adherence, unannounced pill counts conducted in patients' homes are costly and logistically challenging. Telephone-based unannounced pill counts offer a promising adaptation that resolves most of the limitations of home-based pill counting.
  
  
  OBJECTIVE
  We tested the reliability and criterion-related validity of a telephone-based unannounced pill count assessment of antiretroviral adherence.
  
  
  METHODS
  HIV-positive men and women (N = 89) in Atlanta, Georgia, completed a telephone-based unannounced pill count and provided contemporaneous blood specimens to obtain viral loads; 68 participants also received an immediate second pill count conducted during an unannounced home visit.
  
  
  RESULTS
  A high degree of concordance was observed between the number of pills counted on the telephone and in the home (intraclass correlation [ICC] = .981, p < .001) and percent of pills taken (ICC = .987, p < .001). Adherence obtained by the telephone count and home count reached 92% agreement (Kappa coefficient = .94). Adherence determined by telephone-based pill counts also corresponded with patient viral load, providing evidence for criterion-related validity.
  
  
  CONCLUSIONS
  Unannounced telephone-based pill counts offer a feasible objective method for monitoring medication adherence.
authors.affiliation: Department of Psychology, University of Connecticut, Storrs, Connecticut 06269, USA. seth.k@uconn.edu
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.forename: Christina M
authors.initials: CM
authors.lastname: Amaral
authors.forename: Chauncey
authors.initials: C
authors.lastname: Cherry
authors.forename: Jody
authors.initials: J
authors.lastname: Flanagan
authors.forename: Howard
authors.initials: H
authors.lastname: Pope
authors.forename: Lisa
authors.initials: L
authors.lastname: Eaton
authors.forename: Moira O
authors.initials: MO
authors.lastname: Kalichman
authors.forename: Demetria
authors.initials: D
authors.lastname: Cain
authors.forename: Mervi
authors.initials: M
authors.lastname: Detorio
authors.forename: Angela
authors.initials: A
authors.lastname: Caliendo
authors.forename: Raymond F
authors.initials: RF
authors.lastname: Schinazi
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D019538:Health Care Surveys / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019562:Viral Load; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents