title: Assessing adherence to multiple medications and in daily life among patients with multimorbidity.
abstract: OBJECTIVE
  Chronic conditions often require multiple medication intake. However, past research has focused on assessing overall adherence or adherence to a single index medication only. This study explored adherence measures for multiple medication intake, and in daily life, among patients with multiple chronic conditions (i.e. multimorbidity).
  
  
  METHODS
  Eighty-four patients with multimorbidity and multiple-medication regimens completed three monthly panel questionnaires. A randomly assigned subsample additionally completed a 30-day daily diary.
  
  
  METHODS
  The Non-Adherence Report; a brief self-report measure of adherence to each prescribed medication (NAR-M), and in daily life. We further assessed the Medication Adherence Report Scale (MARS), and a subsample of participants were randomised to electronic adherence monitoring.
  
  
  RESULTS
  The NAR-M indicated M = 94.7% adherence at Time 1 (SD = 9.3%). The NAR-M was significantly correlated with the MARS (rt1= .52, rt2= .57, and rt3= .65; p < .001), and in tendency with electronically assessed adherence (rt2= .45, rt3= .46, p < .10). Variance components analysis indicated that between-person differences accounted for 10.2% of the variance in NAR-M adherence rates, whereas 22.9% were attributable to medication by person interactions.
  
  
  CONCLUSIONS
  This study highlights the importance and feasibility of studying adherence to multiple medications differentially, and in daily life. Future studies may use these measures to investigate within-person and between-medication differences in adherence.
authors.affiliation: a Department of Psychology , Columbia University , New York , NY , USA.|b Department of Psychology , University of Zurich , Zurich , Switzerland.|c Center of Competence Multimorbidity, University of Zurich , Zurich , Switzerland.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Inauen
authors.affiliation: b Department of Psychology , University of Zurich , Zurich , Switzerland.|g University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich , Zurich , Switzerland.
authors.forename: Walter
authors.initials: W
authors.lastname: Bierbauer
authors.affiliation: b Department of Psychology , University of Zurich , Zurich , Switzerland.
authors.forename: Janina
authors.initials: J
authors.lastname: Lüscher
authors.affiliation: b Department of Psychology , University of Zurich , Zurich , Switzerland.|g University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich , Zurich , Switzerland.
authors.forename: Claudia
authors.initials: C
authors.lastname: König
authors.affiliation: b Department of Psychology , University of Zurich , Zurich , Switzerland.
authors.forename: Robert
authors.initials: R
authors.lastname: Tobias
authors.affiliation: d Department of Psychology , University of Geneva , Geneva , Switzerland.|h Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva , Geneva , Switzerland.|i Swiss National Center of Competences in Research LIVES-Overcoming Vulnerability: Life Course Perspectives , Lausanne , Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ihle
authors.affiliation: c Center of Competence Multimorbidity, University of Zurich , Zurich , Switzerland.|e Cantonal Hospital Olten , Olten , Switzerland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Zimmerli
authors.affiliation: c Center of Competence Multimorbidity, University of Zurich , Zurich , Switzerland.|f Department of Internal Medicine , University Hospital Zurich , Zurich , Switzerland.|g University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich , Zurich , Switzerland.
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Holzer
authors.affiliation: c Center of Competence Multimorbidity, University of Zurich , Zurich , Switzerland.|f Department of Internal Medicine , University Hospital Zurich , Zurich , Switzerland.|g University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich , Zurich , Switzerland.
authors.forename: Edouard
authors.initials: E
authors.lastname: Battegay
authors.affiliation: c Center of Competence Multimorbidity, University of Zurich , Zurich , Switzerland.|f Department of Internal Medicine , University Hospital Zurich , Zurich , Switzerland.|g University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich , Zurich , Switzerland.
authors.forename: Klarissa
authors.initials: K
authors.lastname: Siebenhüner
authors.affiliation: d Department of Psychology , University of Geneva , Geneva , Switzerland.|h Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva , Geneva , Switzerland.|i Swiss National Center of Competences in Research LIVES-Overcoming Vulnerability: Life Course Perspectives , Lausanne , Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kliegel
authors.affiliation: b Department of Psychology , University of Zurich , Zurich , Switzerland.|c Center of Competence Multimorbidity, University of Zurich , Zurich , Switzerland.|g University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich , Zurich , Switzerland.
authors.forename: Urte
authors.initials: U
authors.lastname: Scholz
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000076322:Multimorbidity; D019338:Polypharmacy; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
keywords: electronic medication adherence; multimorbidity; multiple chronic conditions; multiple medications; polypharmacy; self-report