title: Trials and tribulations with electronic medication adherence monitoring in kidney transplantation.
abstract: Medication adherence in kidney transplantation is critical to prevent graft rejection. Testing interventions designed to support patients to take their prescribed medications following a kidney transplant require an accurate measure of medication adherence. In research, the available methods for measuring medication adherence include self-report, pill counts, prescription refill records, surrogate measures of medication adherence and medication bottles with a microchip-embedded cap to record bottle openings. Medication bottles with a microchip-embedded cap are currently regarded as the gold standard measure. This commentary outlines the challenges in measuring medication adherence using electronic medication monitoring of kidney transplant patients recruited from five sites. The challenges included obtaining unanimous stakeholder support for using this method, agreement on an index medication to measure, adequate preparation of the patient and training of pharmacy staff, and how to analyze data when periods of time were not recorded using the electronic adherence measure. Provision of this information will enable hospital and community pharmacists to implement approaches that promote the effective use of this adherence measure for optimal patient outcomes.
authors.affiliation: School of Nursing & Midwifery, Faculty of Medicine, Nursing & Health Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia. Electronic address: allison.williams@monash.edu.
authors.forename: Allison
authors.initials: A
authors.lastname: Williams
authors.affiliation: School of Nursing & Midwifery, Faculty of Medicine, Nursing & Health Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia.
authors.forename: Jac Kee
authors.initials: JK
authors.lastname: Low
authors.affiliation: School of Nursing & Midwifery, Deakin University, 221 Burwood Highway, Burwood, Victoria, Australia; Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria, Australia; Melbourne School of Health Sciences, The University of Melbourne, 161 Barry St, Carlton, Victoria, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Manias
authors.affiliation: The Alfred Hospital, Alfred Health, 55 Commercial Road, P.O. Box 315, Prahran, Victoria 3181, Australia; Centre for Medicine Use and Safety, Monash University, Parkville Campus, 381 Royal Parade, Parkville, Victoria 3052, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Dooley
authors.affiliation: School of Nursing & Midwifery, Faculty of Medicine, Nursing & Health Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Crawford
mesh_terms: D020811:Biomedical Technology / Q000379:methods*; D003157:Community Pharmacy Services / Q000458:organization & administration; D004349:Drug Packaging; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D055118:Medication Adherence; D010595:Pharmacists / Q000458:organization & administration; D010607:Pharmacy Service, Hospital / Q000458:organization & administration; D057566:Self Report
keywords: Interventions; Kidney transplant; Measurement; Medication adherence