Electronic monitors capable of recording and
stamping the time of opening bottles, dispensing
drops (as in the case of glaucoma), or activating a canister (as in the case of asthma) on multiple occasions have been used for approximately 30
years.Rather than providing weekly or monthly averages, these devices provide precise and
detailed insights into patients’ behavior in taking
medication, but they are still indirect methods
of measuring adherence; they do not document
whether the patient actually ingested the correct
drug or correct dose. Patients may open a container
and not take the medication, take the wrong amount
of medication, or invalidate the data by placing the
medication into another container or taking multiple
doses out of the container at the same time. The
cost of electronic monitoring is not covered by insurance,
and thus these devices are not in routine
use. However, this approach provides the most accurate
and valuable data on adherence in difficult
clinical situations and in the setting of clinical trials
and adherence research and has advanced our knowledge of medication-taking behavior.Although certain methods of measuring adherence may be preferred in specific clinical or research settings,
a combination of measures maximizes accuracy.