title: A new taxonomy for describing and defining adherence to medications.
abstract: Interest in patient adherence has increased in recent years, with a growing literature that shows the pervasiveness of poor adherence to appropriately prescribed medications. However, four decades of adherence research has not resulted in uniformity in the terminology used to describe deviations from prescribed therapies. The aim of this review was to propose a new taxonomy, in which adherence to medications is conceptualized, based on behavioural and pharmacological science, and which will support quantifiable parameters. A systematic literature review was performed using MEDLINE, EMBASE, CINAHL, the Cochrane Library and PsycINFO from database inception to 1 April 2009. The objective was to identify the different conceptual approaches to adherence research. Definitions were analyzed according to time and methodological perspectives. A taxonomic approach was subsequently derived, evaluated and discussed with international experts. More than 10 different terms describing medication-taking behaviour were identified through the literature review, often with differing meanings. The conceptual foundation for a new, transparent taxonomy relies on three elements, which make a clear distinction between processes that describe actions through established routines ('Adherence to medications', 'Management of adherence') and the discipline that studies those processes ('Adherence-related sciences'). 'Adherence to medications' is the process by which patients take their medication as prescribed, further divided into three quantifiable phases: 'Initiation', 'Implementation' and 'Discontinuation'. In response to the proliferation of ambiguous or unquantifiable terms in the literature on medication adherence, this research has resulted in a new conceptual foundation for a transparent taxonomy. The terms and definitions are focused on promoting consistency and quantification in terminology and methods to aid in the conduct, analysis and interpretation of scientific studies of medication adherence.
authors.affiliation: AARDEX Group Ltd, Sion, Switzerland. bernard.vrijens@aardexgroup.com
authors.forename: Bernard
authors.initials: B
authors.lastname: Vrijens
authors.forename: Sabina
authors.initials: S
authors.lastname: De Geest
authors.forename: Dyfrig A
authors.initials: DA
authors.lastname: Hughes
authors.forename: Kardas
authors.initials: K
authors.lastname: Przemyslaw
authors.forename: Jenny
authors.initials: J
authors.lastname: Demonceau
authors.forename: Todd
authors.initials: T
authors.lastname: Ruppar
authors.forename: Fabienne
authors.initials: F
authors.lastname: Dobbels
authors.forename: Emily
authors.initials: E
authors.lastname: Fargher
authors.forename: Valerie
authors.initials: V
authors.lastname: Morrison
authors.forename: Pawel
authors.initials: P
authors.lastname: Lewek
authors.forename: Michal
authors.initials: M
authors.lastname: Matyjaszczyk
authors.forename: Comfort
authors.initials: C
authors.lastname: Mshelia
authors.forename: Wendy
authors.initials: W
authors.lastname: Clyne
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Aronson
authors.forename: J
authors.initials: J
authors.lastname: Urquhart
mesh_terms: D016208:Databases, Factual; D019468:Disease Management; D016903:Drug Monitoring / Q000145:classification*; D006801:Humans; D055118:Medication Adherence; D010346:Patient Care Management / Q000145:classification*; D004364:Pharmaceutical Preparations / Q000145:classification*
chemical_list: D004364:Pharmaceutical Preparations