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One possible explanation is the lack of a validated questionnaire designed specifically for the evaluation of adherence to topical treatment.
While this would appear to be a policy worthy of replication elsewhere, it would be unlikely to be effective without enforcement, and there do not appear to be plans to make available information on monitoring or evaluation of adherence to the code.
The Florida Initiative for Quality Cancer Care (FIQCC), composed of 11 practice sites across Florida, conducted its initial evaluation of adherence to breast cancer quality of care indicators (QCI) in 2006, with feedback provided to encourage quality improvement efforts at participating sites.
It should be noted, the study intent is not an evaluation of adherence to guidelines.
Evaluation of adherence was conducted in matched samples, to obtain a standardised view and minimise confounding.
Hence, evaluation of adherence intervention efficacy with adequate comparison controls is not possible.
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The CONSORT statement was excluded, as evaluations of adherence to CONSORT had previously been reviewed.
A recent systematic review of cost-effectiveness evaluations of adherence interventions among patients with other chronic conditions included thirteen randomised controlled trials (unpublished data).
Following a recent review suggesting that cost-effectiveness evaluations of adherence interventions for chronic diseases are rare and that their methodology is poorly described in the literature, this manuscript presents the study protocol for the economic evaluation of AIMS.
Evaluations of adherence have mostly relied on chart reviews and clinician or patient reports which are difficult to complete for a large number of patients across several healthcare settings.
Although many evaluations of adherence interventions naturally assess impact on adherence to medication, the QUATRO study focused on the more over-arching outcome of quality of life (in the expectation that this could be improved via lower symptoms and better functioning) and found no such differences over one year.
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