Indirect methods of measurement of adherence
include asking the patient about how easy it is for him or her to take prescribed medication, assessing
clinical response, performing pill counts, ascertaining
rates of refilling prescriptions, collecting
patient questionnaires, using electronic medication
monitors, measuring physiologic markers, asking
the patient to keep a medication diary, and assessing
children’s adherence by asking the help of a
caregiver, school nurse, or teacher. Questioning the
patient (or using a questionnaire), patient diaries,
and assessment of clinical response are all methods
that are relatively easy to use, but questioning
the patient can be susceptible to misrepresentation
and tends to result in the health care provider’s
overestimating the patient’s adherence