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Comparing Measures of Medication Taking in a Pharmacotherapy Trial for Cocaine Dependence

Mooney, Marc PHD; Sayre, Shelly MPH; Green, Charles MA; Rhoades, Howard PHD; Schmitz, Joy PHD

Addictive Disorders & Their Treatment: December 2004 - Volume 3 - Issue 4 - p 165-173
doi: 10.1097/
Original Article

The purpose of this study was to compare compliance estimates based on 3 methods of measuring medication taking: self-report, an electronic medication event measurement system (MEMS), and a biochemical tracer (riboflavin). During the first 4 weeks of a placebo-controlled, double-blind trial, cocaine-dependent participants (N = 55) took their assigned study medications and provided data to assess daily pill-taking behavior. MEMS-based estimates of medication compliance were substantially lower than riboflavin or self-report (28%, 78%, and 87%, respectively). Using MEMS as a reference or “gold standard,” self-report, riboflavin, and their combination demonstrated poor ability to detect non-compliance (AUCs < 0.60). Medication compliance rates vary depending on measurement method, with subjective reports more likely to overestimate actual pill-taking behavior.

From the Substance Abuse Research Center, University of Texas, Houston.

Supported by a grant from the National Institute on Drug Abuse, Grant DA-09262-02.

Reprints: Marc Mooney, PhD, Department of Psychiatry and Behavioral Sciences, University of Texas, Houston, 1300 Moursund, Houston, Texas 77030 (e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.