A framework for understanding sources of bias in medication adherence research

Research output: Contribution to journalArticlepeer-review

Electronic versions

Documents

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
Pages (from-to)3444-3453
JournalBritish Journal of Clinical Pharmacology
Volume89
Issue number11
Early online date26 Jul 2023
DOIs
Publication statusPublished - Nov 2023
View graph of relations