title: Adherence of antidepressants during pregnancy: MEMS compared with three other methods.
abstract: BACKGROUND
  Data about adherence of antidepressants during pregnancy are lacking. However, it is important to gain insight into adherence in this population to reduce perinatal risks for relapse of depression.
  
  
  OBJECTIVE
  The objective of this study was to search for an inexpensive and easy method to implement daily for assessing medication adherence during pregnancy.
  
  
  METHODS
  An observational study was conducted to measure adherence by comparing pill count, Beliefs about Medicine questionnaire (BMQ) and blood level monitoring against the standard, the Medication Event Monitoring System (MEMS). We used a logistic regression model to determine potential predictors for poor adherence (age, marital class, highest level of education, monthly net income, employment, smoking, alcohol use and type of antidepressant).
  
  
  RESULTS
  From January 2010 until January 2012, 41 women were included within the first trimester of pregnancy; data could be evaluated in 29 women. Using MEMS, 86% of the women took in more than 80% of all prescribed doses on time and could be classified as adherent. Pill counts showed good agreement with MEMS. We did not find predictors for poor adherence in our study population.
  
  
  CONCLUSIONS
  Adherence of antidepressants during pregnancy using MEMS is 86%. There was a good agreement between MEMS and pill counts. This method may serve as a good alternative that can be easily implemented into daily practice.
authors.affiliation: Department of Clinical Pharmacy, Isala Clinics, Dr. van Heesweg 2, Zwolle, The Netherlands.
authors.forename: Judith
authors.initials: J
authors.lastname: Bosman
authors.affiliation: Department of Clinical Chemistry, Isala Clinics, Zwolle, The Netherlands.
authors.forename: Peter G J
authors.initials: PG
authors.lastname: Ter Horst
authors.affiliation: Department of Psychiatry, Isala Clinics, Zwolle, The Netherlands.
authors.forename: Jan Pieter
authors.initials: JP
authors.lastname: Smit
authors.affiliation: Department of Gynaecology and Obstetrics, Isala Clinics, Zwolle, The Netherlands.
authors.forename: Jeroen R
authors.initials: JR
authors.lastname: Dijkstra
authors.affiliation: Department of Gynaecology and Obstetrics, Isala Clinics, Zwolle, The Netherlands.
authors.forename: Hans R
authors.initials: HR
authors.lastname: Beekhuis
authors.affiliation: Department of Clinical Chemistry, Isala Clinics, Zwolle, The Netherlands.
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: Slingersland
authors.affiliation: Department of Clinical Pharmacy, Isala Clinics, Zwolle, The Netherlands.
authors.forename: Wobbe
authors.initials: W
authors.lastname: Hospes
keywords: Antidepressants; BMQ; MEMS; TDM; adherence; pill count; pregnancy