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The PBM data we analyzed may have captured more adherence data for subcutaneous biologics than other commercial claims databases.
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We had previously speculated that the cognitive process of coming up with an adjectival rating appeared to correspond more closely to objective adherence data because it mapped more closely onto the cognitive process that patients used to form responses, which we thought was probably more an estimation process than an enumeration process.
Our analysis depicts a considerably more nuanced picture of adherence and emphasizes the need for more standardised approaches to reporting adherence data in order to facilitate interpretation of trial results and comparisons across trials of similar interventions.
This may be particularly valuable if laboratory monitoring can be integrated with adherence data to focus interventions on priority patients who need more support.
Finally, acceptability and adherence data from ongoing and completed trials can contribute importantly to more realistic designs for future trials.
Further studies should gather more objective measures of diagnosis and treatment information from patient medical records and adherence data, to corroborate any self-reported data.
For analysis of factors associated with MEMS adherence, data was aggregated into 12-week periods for each child, reducing random fluctuation and allowing a more prolonged effect of cofactors.
There was no published evidence for provider adherence data.
Provision of adherence data to providers may motivate patients to improve adherence and help providers identify adherence barriers.
The fact that we studied adherence among patients retained in care, but lacked adherence data on patients LTFU, may have introduced a potential systematic bias underestimating the true risk of low adherence since patients that remain in the programme are more likely to be adherent.
The adherence data collected indicated high levels of adherence in each arm.
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