Measuring adherence among HIV-infected persons: Is MEMS consummate technology?

The measurement of adherence to antiretroviral medications has become a major focus of HIV research. Accurate means of assessing adherence is critical. The HIV epidemic has provided unique challenges in the quest to accurately determine adherence to medications. The strengths and weaknesses of the most common means for assessing adherence are briefly reviewed. Case studies from a research study assessing adherence in alcohol abusing patients with HIV are presented to illustrate the actual use of the Medication Events Monitoring System “MEMS” and patient self-report in a clinical research setting. Practical recommendations for optimizing measurement of adherence are provided. In research studies examining adherence to HIV medications, MEMS's potential to provide detailed accurate adherence information may be quite limited because of the complexity of the regimen, patient lifestyle factors, and the use of adherence aids such as pill boxes. Innovative measurement of medication adherence remains a critical research priority.