A new taxonomy for describing and defining adherence to medications

A new taxonomy for describing and defining adherence to medications! That's a fascinating topic. Here's a potential framework for a new taxonomy:

Adherence Taxonomy (AT)

The Adherence Taxonomy (AT) is a hierarchical system that categorizes adherence to medications into distinct levels, each representing a specific aspect of medication-taking behavior. The AT consists of three main categories: Frequency, Duration, and Quality.

Category 1: Frequency

• Adherence Level 1: Non-Adherent (0-20% of prescribed doses taken)
  • Definition: The patient does not take any or only a few doses of the medication as prescribed.
• Adherence Level 2: Partially Adherent (21-60% of prescribed doses taken)
  • Definition: The patient takes some, but not all, of the prescribed doses.
• Adherence Level 3: Adherent (61-100% of prescribed doses taken)
  • Definition: The patient takes all or nearly all of the prescribed doses.

Category 2: Duration

• Adherence Level 4: Short-Term Non-Adherent (less than 30 days of adherence)
  • Definition: The patient does not take the medication for a short period, but may resume taking it later.
• Adherence Level 5: Long-Term Adherent (30 days or more of adherence)
  • Definition: The patient takes the medication consistently for an extended period.

Category 3: Quality

• Adherence Level 6: Inconsistent Adherent (variable adherence patterns)
  • Definition: The patient takes the medication at irregular intervals or in inconsistent dosages.
• Adherence Level 7: Consistent Adherent (consistent adherence patterns)
  • Definition: The patient takes the medication as prescribed, with minimal variations.

Additional Dimensions

To further refine the taxonomy, consider adding the following dimensions:

• Reasons for Non-Adherence: Identify the underlying reasons for non-adherence, such as forgetfulness, side effects, or lack of understanding.
• Patient Characteristics: Consider factors like age, gender, education level, and socioeconomic status, which may influence adherence.
• Medication Characteristics: Take into account the complexity of the medication regimen, dosing frequency, and potential side effects.

Benefits of the Adherence Taxonomy

1. Improved communication: The AT provides a standardized language for healthcare providers, patients, and researchers to discuss adherence.
2. Enhanced patient engagement: By understanding the specific aspects of adherence, patients can better identify areas for improvement.
3. More accurate measurement: The AT allows for more precise measurement of adherence, enabling researchers to identify trends and patterns.
4. Personalized interventions: Healthcare providers can tailor interventions to address specific adherence challenges, such as frequency, duration, or quality.

Future Directions

1. Validation studies: Conduct studies to validate the AT and ensure its reliability and accuracy.
2. Integration with existing frameworks: Explore opportunities to integrate the AT with existing frameworks, such as the World Health Organization's (WHO) Adherence to Long-Term Therapies (ATL) scale.
3. Development of adherence metrics: Create metrics to quantify adherence using the AT, enabling researchers to track progress and evaluate the effectiveness of interventions.

By developing a comprehensive taxonomy for describing and defining adherence to medications, we can improve patient outcomes, enhance healthcare provider-patient communication, and advance our understanding of medication adherence.