A framework for understanding sources of bias in medication adherence research

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  • Main_text_BJCP_FINAL

    Accepted author manuscript, 285 KB, PDF document

    Embargo ends: 26/07/24

DOI

  • Klarissa A Sinnappah
    University of Otago
  • Dyfrig Hughes
  • Sophie L Stocker
    University of Sydney
  • Bernard Vrijens
    University of Liege
  • Jeffrey K Aronson
    University of Oxford
  • Daniel F B Wright
    University of Otago
The sources of bias in medication adherence research have not been comprehensively explored. We aimed to identify biases expected to affect adherence research and to develop a framework for mapping these onto the phases of adherence (initiation, implementation and discontinuation). A literature search was conducted, key papers were reviewed and a Catalogue of Bias was consulted. The specific biases related to adherence measurement and metrics were mapped onto the phases of adherence using a tabular matrix. Twenty-three biases were identified, of which 11 were specifically relevant to adherence measures and metrics. The mapping framework showed differences in the numbers and types of biases associated with each measure and metric while highlighting those common to many adherence study designs (e.g., unacceptability bias and apprehension bias). The framework will inform the design of adherence studies and the development of risk of bias tools for adherence research.
Original languageEnglish
JournalBritish Journal of Clinical Pharmacology
Early online date26 Jul 2023
DOIs
Publication statusE-pub ahead of print - 26 Jul 2023
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