ORIGINAL ARTICLE Does Electronic Monitoring Influence Adherence to Medication? Randomized Controlled Trial of Measurement Reactivity

# The Author(s) 2014. This article is published with open access at Springerlink.com Background Electronic monitoring is recommended for ac-curate measurement of medication adherence but a possible limitation is that it may influence adherence. Purpose To test the reactive effect of electronic monitoring in a randomized controlled trial. Methods A total of 226 adults with type 2 diabetes and HbA1c ≥58 mmol/mol were randomized to receiving their main oral glucose lowering medication in electronic con-tainers or standard packaging. The primary outcomes were self-reported adherence measured with the MARS (Medica-tion Adherence Report Scale; range 5–25) and HbA1c at 8 weeks. Results Non-significantly higher adherence and lower HbA1c were observed in the electronic container group (differences in means, adjusting for baseline value: MARS, 0.4 [95 % CI −0.1 to 0.8, p=0.11]; HbA1c (mmol/mol), −1.02 [−2.73 to 0.71, p=0.25]). Conclusions Electronic containers may lead to a small in-crease in adherence but this potential limitation is outweighed by their advantages. Our findings support elec-tronic monitoring as the method of choice in research on medication adherence. (Trial registration Current Con