Standardizing terminology and definitions of medication adherence and persistence in research employing electronic databases.
Standardizing terminology and definitions of medication adherence and persistence in research employing electronic databases.
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DOI：
10.1097/mlr.0b013e31829b1d2a
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发表时间：
2013-08
期刊：
影响因子：
3
通讯作者：
Steiner JF
中科院分区：
文献类型：
--
作者：
Raebel MA;Schmittdiel J;Karter AJ;Konieczny JL;Steiner JF
利用电子健康记录处方数据库、处方配药数据库和药房索赔数据库，为处方依从性研究提出一套统一的定义，并提供一个概念框架，以便在研究中一致地实施这些定义。我们回顾了最近的文献，以确定电子数据库研究中慢性口服药物处方配药模式的定义。然后，我们开发一个概念模型并提出标准化术语和定义来描述电子数据库中的处方配药行为。我们提出的概念模型定义了两个独立的结构：药物依从性和持久性。我们将主要依从性和次要依从性定义为不同的依从性子类型。对估计次要依从性的指标进行了讨论和批评，包括一个新的指标（新处方药差距测量），该指标可以估计主要和次要依从性。目前使用电子数据库的处方依从性研究中使用的术语缺乏一致性。我们为此类研究提出了一个清晰、一致、广泛适用的概念模型和术语。该模型和定义有助于利用电子药物处方、配药和/或索赔数据库进行研究，并涵盖处方配药行为的整个连续体。采用概念清晰且一致的术语来定义药物依从性和持久性将有助于未来利用电子处方和配药记录进行比较有效性研究和荟萃分析研究。
To propose a unifying set of definitions for prescription adherence research utilizing electronic health record prescribing databases, prescription dispensing databases, and pharmacy claims databases and to provide a conceptual framework to operationalize these definitions consistently across studies. We reviewed recent literature to identify definitions in electronic database studies of prescription-filling patterns for chronic oral medications. We then develop a conceptual model and propose standardized terminology and definitions to describe prescription-filling behavior from electronic databases. The conceptual model we propose defines two separate constructs: medication adherence and persistence. We define primary and secondary adherence as distinct sub-types of adherence. Metrics for estimating secondary adherence are discussed and critiqued, including a newer metric (New Prescription Medication Gap measure) that enables estimation of both primary and secondary adherence. Terminology currently used in prescription adherence research employing electronic databases lacks consistency. We propose a clear, consistent, broadly applicable conceptual model and terminology for such studies. The model and definitions facilitate research utilizing electronic medication prescribing, dispensing, and/or claims databases and encompasses the entire continuum of prescription-filling behavior. Employing conceptually clear and consistent terminology to define medication adherence and persistence will facilitate future comparative effectiveness research and meta-analytic studies that utilize electronic prescription and dispensing records.