***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective The goal of this study was to evaluate clinical ly the acceptability of the IDAS II ( Intelligent Drug Administration System ) , a new electronic device that enables drug adherence monitoring . Methods IDAS II was compared to another electronic monitor , the Medication Event Monitoring System ( MEMS ) in a r and omised two-way cross-over study involving 24 hypertensive patients treated with irbesartan .  Patients used each device for 2 months . The main parameter of evaluation was the patients ’ opinion on both devices . Rates of adherence and blood pressure were also assessed . Results Most patients considered both devices to be reliable reminders ( IDAS II : 75%;MEMS : 84 % , p = ns ) . Ten patients ( 42 % ) preferred the MEMS , while 11 ( 46 % ) preferred the IDAS II ; three ( 12 % ) expressed no preference . Patients found the MEMS device easier to use than the IDAS device ( p < 0.001 ) but appreciated the IDAS blister packs better than the MEMS bulk packaging ( p < 0.01 ) . Over the 4-month period , the median “ taking adherence ” was excellent ( 99.2 % ) and comparable with both devices . However , the regularity of drug intake timing was higher with the IDAS II ( p < 0.01 ) . Conclusion IDAS II , a new electronic device enabling drug adherence monitoring without reconditioning of the drugs appears to be a well-accepted device . Overall , practicability and acceptability of the IDAS II and the MEMS device were similar . Thus , IDAS II could be a useful tool for the management of long-term therapies Objective : To assess the association between adherence to antiretroviral therapy and the presence of class-specific antiretroviral medication resistance . Design : Secondary analysis of prospect i ve clinical trial data . Methods : Participants r and omized to the protease inhibitor or nonnucleoside reverse transcriptase inhibitor ( NNRTI ) strategies of the Community Programs for Clinical Research on AIDS ( CPCRA ) Flexible Initial Retrovirus Suppressive Therapies ( FIRST ) Study were included . Adherence was measured by 7-day self-report . Virological failure was defined as an HIV-RNA more than 1000 at or after 4 months . The association between cumulative adherence and the development of class-specific genotypic resistance was assessed by Cox regression analysis . Results : Included were 457 and 446 antiretroviral-naive participants on the protease inhibitor and NNRTI strategies , respectively . The median time to initial virological failure in the protease inhibitor strategy was 1.2 years ; 135 ( 30 % ) individuals failed with resistance . The median time to initial virological failure in the NNRTI strategy was 3.0 years ; 127 ( 28 % ) failed with resistance . No association was found between cumulative adherence and protease inhibitor resistance [ hazard ratio 1.1 , 95 % confidence interval ( CI ) 0.9–1.4 per 10 % lower adherence ] . However , lower cumulative adherence was associated with an increased risk of NNRTI resistance at initial virological failure ( hazard ratio 1.2 , 95 % CI 1.1–1.3 per 10 % lower adherence ) . In both strategies , lower cumulative adherence was associated with an increased risk of nucleoside reverse transcriptase inhibitor ( NRTI ) resistance at initial virological failure . Conclusion : Adherence – resistance relationships are class-specific . For NRTIs and NNRTIs , initial virological failure with resistance is more likely at lower levels of cumulative adherence OBJECTIVE The most common ways of assessing adherence to oral antipsychotic medications in research and in clinical practice are self-report and physician report . This prospect i ve study examined the agreement among measures of adherence to oral antipsychotic medications among 52 out patients with schizophrenia . METHODS Participants were assessed at baseline during a visit to their outpatient clinic and followed for 12 weeks . Adherence was assessed by using subjective measures ( self-report and physician report ) and objective measures ( pill counts conducted in the home , electronic monitoring , and blood plasma concentrations ) . Electronic monitoring was used as an imperfect st and ard against which other methods were judged . RESULTS Data from pill counts and from electronic monitoring were strongly correlated ( r(k)=.61 ) . Self-report and physicians ' ratings of compliance were weakly correlated with pill count and electronic monitoring when compliance scores were examined with rank-order correlations ( r(k)=.18-.32 ) . When the sample was dichotomized into adherent and nonadherent groups on the basis of electronic monitoring or pill count ( at least 80 % adherent ) , neither physicians nor patients identified adherent behavior ( kappa < or=20 ) . Blood plasma concentrations were not correlated with any other measures of adherence ( kappa < or=20 ) . Self-report and physician report were best correlated with clinical state ( r(k)=-.27 , r(k)=-.25 ) , suggesting that patients and treating professionals may use clinical state to estimate adherence . CONCLUSIONS Patients and physicians were not able to identify adherence . The inability of physicians to accurately identify adherent individuals is likely to have important consequences for prescribing behavior , health care costs , and patient outcomes BACKGROUND Nonadherence to physician treatment recommendations is an increasingly recognized cause of adverse outcomes and increased health care costs , particularly among patients with cardiovascular disease . Whether patient self-report can provide an accurate assessment of medication adherence in out patients with stable coronary heart disease is unknown . METHODS We prospect ively evaluated the risk of cardiovascular events associated with self-reported medication nonadherence in 1015 out patients with established coronary heart disease from the Heart and Soul Study . We asked participants a single question : " In the past month , how often did you take your medications as the doctor prescribed ? " Nonadherence was defined as taking medications as prescribed 75 % of the time or less . Cardiovascular events ( coronary heart disease death , myocardial infa rct ion , or stroke ) were identified by review of medical records during 3.9 years of follow-up . We used Cox proportional hazards analysis to determine the risk of adverse cardiovascular events associated with self-reported medication nonadherence . RESULTS Of the 1015 participants , 83 ( 8.2 % ) reported nonadherence to their medications , and 146 ( 14.4 % ) developed cardiovascular events . Nonadherent participants were more likely than adherent participants to develop cardiovascular events during 3.9 years of follow-up ( 22.9 % vs 13.8 % , P = .03 ) . Self-reported nonadherence remained independently predictive of adverse cardiovascular events after adjusting for baseline cardiac disease severity , traditional risk factors , and depressive symptoms ( hazards ratio , 2.3 ; 95 % confidence interval , 1.3 - 4.3 ; P = .006 ) . CONCLUSIONS In out patients with stable coronary heart disease , self-reported medication nonadherence is associated with a greater than 2-fold increased rate of subsequent cardiovascular events . A single question about medication adherence may be a simple and effective method to identify patients at higher risk for adverse cardiovascular events The relationship between adherence to highly active antiretroviral therapy ( HAART ) and RNA-HIV viral load outcomes has been extensively shown . Although there are different procedures for assessing treatment adherence , there is no ideal method . We present the SERAD ( Self-Reported Adherence ) question naire , a qualitative and quantitative self-reported instrument design ed to provide an easier adherence measurement . We also compared the question naire to three other methods to evaluate adherence to HAART regimens in HIV-infected patients . Two prospect i ve , observational , longitudinal studies were developed : a single-center pilot study followed by a multicenter study . A total of 530 HIV-infected out patients was prospect ively included , 66 in the pilot study and 464 in the multicenter study . Four methods were used to study adherence to HAART regimens : the SERAD question naire , pill count , electronic monitoring , and  plasma drug monitoring . Pearson 's correlations and Bl and and Altman 's method were developed . The SERAD question naire showed good feasibility and significant validity . Adequate levels of agreement between methods were observed , particularly when adherence was high . Differences increased as adherence fell . Moreover , the question naire was completed correctly , the interviewers did not report uncovered aspects , and the information was collected easily . Our results suggest that the SERAD question naire is a feasible and useful instrument for assessing adherence to HAART regimens in HIV-infected patients , and makes it possible to obtain reliable qualitative and quantitative information related to treatment adherence Background : Poor adherence to oral osteoporosis medications is common . Strategies for improving adherence begin with identification of the problem . The 8-item Morisky Medication Adherence Scale for self-reported adherence to antihypertensive medications was modified for assessing adherence to oral osteoporosis medications . An evaluation of the measurement properties of the Osteoporosis-Specific Morisky Medication Adherence Scale  ( OS-MMAS ) was needed . Objective : To examine the psychometric properties of the OS-MMAS in women with postmenopausal osteoporosis . Methods : Five hundred women aged 55 years and older with osteoporosis who were newly prescribed daily or weekly oral bisphosphonates between May 15 , 2010 , and August 15 , 2010 , were r and omly selected from Kaiser Permanente Southern California , a large integrated health care delivery system , and mailed a self-administered survey  that included the 8-item OS-MMAS , Self-Efficacy for Appropriate Medication Use Scale ( SEAMS ) , Beliefs about Medicines Question naire ( BMQ ) , Treatment Satisfaction Question naire for Medication ( TSQM ) , Gastrointestinal Symptom Rating Scale ( GSRS ) , and 12-item Short-Form Health Survey ( SF-12v2 ) . OS-MMAS scores can range from 0 to 8 , with higher scores indicating better medication adherence . Internal consistency reliability was evaluated using Cronbach α coefficient . Test-retest reliability was assessed using intraclass correlation coefficients ( ICCs ) in a subset of 102 participants . Construct validity was assessed using confirmatory ( actor analysis and correlations between OS-MMAS and related measures . Results : Of 197 participants , 150 reported that they were still taking their bisphosphonate at the time of the survey and completed the OS-MMAS . Overall , 30.7 % , 32.7 % , and 36.7 % had tow , medium , and high  OS-MMAS scores ( < 6 , 6 to < 8 , and 8 , respectively ) . Cronbach α was 0.82 and the ICC was 0.77 . Convergent validity was supported by significant correlations with SEAMS , BMQ necessity , and TSQM scores . In confirmatory factor analysis , a single-factor scale was supported . Conclusions : The OS-MMAS showed strong psychometric properties with good reliability and construct validity and may provide a valuable assessment of self-reported medication adherence in women newly prescribed oral osteoporosis medications Background Patient adherence is an important component of the treatment of chronic disease . An underst and ing of patient adherence and its modulating factors is necessary to correctly interpret treatment efficacy and barriers to therapeutic success . Purpose This meta- analysis aims to systematic ally review published r and omized controlled trials of reminder interventions to assist patient adherence to prescribed medications . Methods A Medline search was performed for r and omized controlled trials published between 1968 and June 2011 , which studied the effect of reminder-based interventions on adherence to self-administered daily medications . Results Eleven published r and omized controlled trials were found between 1999 and 2009 which measured adherence to a daily medication  in a group receiving reminder interventions compared to controls receiving no reminders .  Medication adherence was measured as the number of doses taken compared to the number prescribed within a set period of time . Meta- analysis showed a statistically significant increase in adherence in groups receiving a reminder intervention compared to controls ( 66.61 % versus 54.71 % , 95 % CI for mean : 0.8 % to 22.4 % ) . Self-reported and electronically monitored adherence rates did not significantly differ ( 68.04 % versus 63.67 % , P = 1.0 ) . Eight of eleven studies showed a statistically significant increase in adherence for at least one of the reminder group arms compared to the control groups receiving no reminder intervention . Limitations The data are limited by imperfect measures of adherence due to variability in data collection methods . It is also likely that concomitant educational efforts in the study population s , such as instructions regarding proper administration and importance of correct dosing schedules , contributed to improved patient adherence , both in reminder and control arms . The search strategy could have missed relevant studies which were categorized by disease rather than adherence . Conclusions Reminder-based interventions may improve adherence to daily medications . However , the interventions used in these studies , which included reminder phone calls , text messages , pagers , interactive voice response systems , videotelephone calls , and programmed electronic audiovisual reminder devices , are impractical for widespread implementation , and their efficacy may be optimized when combined with alternative adherence-modifying strategies . More practical reminder-based interventions should be assessed to determine their value in improving patient adher 
    Output:
    
Supporting patients to be adherent requires information on their medication-taking behaviour , barriers to adherence and beliefs about medicines .
Adherence scales have the potential to explore these aspects of adherence , but currently there has been a greater focus on measuring medication-taking behaviour .