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Unannounced Telephone-Based Pill Counts: A Valid and Feasible Method for Monitoring Adherence

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Abstract

Phone-based unannounced pill counts to measure medication adherence are much more practical and less expensive than home-based unannounced pill counts, but their validity has not been widely assessed. We examined the validity of phone versus home-based pill counts using a simplified protocol streamlined for studies embedded in clinical care settings. A total of 100 paired counts were used to compare concordance between unannounced phone and home-based pill counts using interclass correlations. Discrepancy analyses using χ2 tests compared demographic and clinical characteristics across patients who were concordant between phone and home-based pill counts and patients who were not concordant. Concordance was high for phone-based and home-based unannounced total pill counts, as well as individual medication counts and calculated adherence. This study demonstrates that a simplified phone-based pill count protocol can be implemented among patients from a routine clinical care setting and is a feasible means of monitoring medication adherence.

Resumen

Los conteos no anunciados de comprimidos por teléfono, con el propósito de medir el cumplimiento con respecto a los medicamentos, es mucho más práctico y menos costoso que los conteos no anunciados de comprimidos en el hogar, pero su validez no se ha evaluado en forma amplia. Examinamos la validez de los conteos no anunciados de comprimidos en el hogar, mediante el uso de un protocolo racionalizado para estudios integrados en ambientes de atención clínica. Un total de 100 conteos en pares se usaron para comparar la concordancia entre los conteos no anunciados de comprimidos por teléfono y en el hogar con correlaciones entre clases. Los análisis de discrepancia mediante pruebas χ2 compararon características demográficas y clínicas en los pacientes que fueron concordantes entre los conteos de comprimidos por teléfono y en el hogar y los pacientes que no fueron concordantes. Hubo una alta concordancia para los conteos no anunciados totales de comprimidos por teléfono y en el hogar, al igual que para los conteos de medicamentos individuales y para el cumplimiento calculado. Este estudio demuestra que se puede implementar un protocolo simplificado de conteo de comprimidos por teléfono entre los pacientes de un entorno de atención clínica de rutina y que es un medio factible para controlar el cumplimiento con respecto a los medicamentos.

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Acknowledgments

We would like to acknowledge the patients and providers of the UW Madison HIV clinic. Seth Kalichman generously provided protocols for phone-based pill counts and provided other insights that allowed this project to occur. This study and different aspects of the data were supported by Grants from the NIH NIMH RO1 Grant (RO1 MH084759), NIH PROMIS Roadmap (U01 AR057954-S1), the University of Washington Center for AIDS Research NIAID Grant (P30 AI027757), NIAAA ARCH-ERA U24 AA020801, U01AA020793, and the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) Grant (R24 AI067039).

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Authors and Affiliations

  1. Department of Medicine, University of Washington, Seattle, WA, USA

    R. Fredericksen, B. J. Feldman, T. Brown, S. Schmidt, P. K. Crane, R. D. Harrington, S. Dhanireddy, J. McReynolds, W. B. Lober, M. M. Kitahata & Heidi M. Crane

  2. Harvard School of Public Health, Harvard, Cambridge, MA, USA

    D. R. Bangsberg

  3. Harborview Medical Center, 325 9th Ave, Box 359931, Seattle, WA, 98104, USA

    Heidi M. Crane

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  1. R. Fredericksen
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  2. B. J. Feldman
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  3. T. Brown
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  4. S. Schmidt
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  5. P. K. Crane
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  6. R. D. Harrington
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  7. S. Dhanireddy
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  8. J. McReynolds
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  9. W. B. Lober
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  10. D. R. Bangsberg
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  11. M. M. Kitahata
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  12. Heidi M. Crane
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Correspondence to Heidi M. Crane.

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Fredericksen, R., Feldman, B.J., Brown, T. et al. Unannounced Telephone-Based Pill Counts: A Valid and Feasible Method for Monitoring Adherence. AIDS Behav 18, 2265–2273 (2014). https://doi.org/10.1007/s10461-014-0916-7

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