title: Does electronic monitoring influence adherence to medication? Randomized controlled trial of measurement reactivity.
abstract: BACKGROUND
  Electronic monitoring is recommended for accurate measurement of medication adherence but a possible limitation is that it may influence adherence.
  
  
  OBJECTIVE
  To test the reactive effect of electronic monitoring in a randomized controlled trial.
  
  
  METHODS
  A total of 226 adults with type 2 diabetes and HbA1c ≥58 mmol/mol were randomized to receiving their main oral glucose lowering medication in electronic containers or standard packaging. The primary outcomes were self-reported adherence measured with the MARS (Medication Adherence Report Scale; range 5-25) and HbA1c at 8 weeks.
  
  
  RESULTS
  Non-significantly higher adherence and lower HbA1c were observed in the electronic container group (differences in means, adjusting for baseline value: MARS, 0.4 [95 % CI -0.1 to 0.8, p = 0.11]; HbA1c (mmol/mol), -1.02 [-2.73 to 0.71, p = 0.25]).
  
  
  CONCLUSIONS
  Electronic containers may lead to a small increase in adherence but this potential limitation is outweighed by their advantages. Our findings support electronic monitoring as the method of choice in research on medication adherence. (Trial registration Current Controlled Trials ISRCT N30522359).
authors.affiliation: Behavioural Science Group, Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK, srs34@medschl.cam.ac.uk.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sutton
authors.forename: Ann-Louise
authors.initials: AL
authors.lastname: Kinmonth
authors.forename: Wendy
authors.initials: W
authors.lastname: Hardeman
authors.forename: Dyfrig
authors.initials: D
authors.lastname: Hughes
authors.forename: Sue
authors.initials: S
authors.lastname: Boase
authors.forename: A Toby
authors.initials: AT
authors.lastname: Prevost
authors.forename: Ian
authors.initials: I
authors.lastname: Kellar
authors.forename: Jonathan
authors.initials: J
authors.lastname: Graffy
authors.forename: Simon
authors.initials: S
authors.lastname: Griffin
authors.forename: Andrew
authors.initials: A
authors.lastname: Farmer
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004349:Drug Packaging / Q000295:instrumentation / Q000592:standards*; D055615:Electrical Equipment and Supplies / Q000592:standards; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents