Research and Reporting Methods
26 June 2018

ESPACOMP Medication Adherence Reporting Guideline (EMERGE)

Publication: Annals of Internal Medicine
Volume 169, Number 1


Research on assessing or managing medication adherence applies approaches from observational, interventional, and implementation science that spans many disciplines and demands coherent conceptualization, valid methods, appropriate analyses, and complete and accurate reporting. To ensure such reporting, the European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) Medication Adherence Reporting Guideline (EMERGE) recommends standard reporting approaches based on an accepted taxonomy.
This guideline is derived from a literature review, a reactive Delphi study with 26 medication adherence experts from many countries and disciplines, and feedback from ESPACOMP members. It is designed to supplement existing guidelines for health research reporting and is structured around 4 minimum reporting criteria and 17 items reflecting best reporting practice. By enhancing and harmonizing research reporting, EMERGE aims to advance research and, ultimately, patient outcomes.

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Information & Authors


Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 169Number 13 July 2018
Pages: 30 - 35


Published online: 26 June 2018
Published in issue: 3 July 2018




Sabina De Geest, PhD, RN
University of Basel, Basel, Switzerland, and Academic Centre for Nursing and Midwifery, Katholieke Universiteit Leuven, Leuven, Belgium (S.D.)
Leah L. Zullig, PhD, MPH
Center for Health Services Research in Primary Care at Durham Veterans Affairs Health Care System and Duke University School of Medicine, Durham, North Carolina (L.L.Z.)
Jacqueline Dunbar-Jacob, PhD, RN
University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania (J.D.)
Remon Helmy, MSc
University of Basel, Basel, Switzerland (R.H.)
Dyfrig A. Hughes, MRPharmS, PhD
Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, North Wales, United Kingdom (D.A.H.)
Ira B. Wilson, MD, PhD
Brown University School of Public Health, Providence, Rhode Island (I.B.W.)
Bernard Vrijens, PhD
University of Liège, Liège, Belgium, and AARDEX Group, Visé, Belgium (B.V.)
Acknowledgment: The authors thank ESPACOMP for support in developing EMERGE. They also thank the EMERGE expert panel for participating in the 2 Delphi survey rounds, including the following persons who agreed to be mentioned by name: Darren Ashcroft (University of Manchester, Manchester, United Kingdom), Anne Beal (Sanofi, Paris, France), Terrence Blaschke (Stanford University, Stanford, California; Bill and Melinda Gates Foundation, Seattle, Washington; and University of California, San Francisco, San Francisco, California), Hayden Bosworth (Duke University and Durham Veterans Affairs Medical Center, Durham, North Carolina), Rhiannon Braund (School of Pharmacy, University of Otago, Dunedin, New Zealand), Timothy Chen (University of Sydney, Sydney, New South Wales, Australia), Niteesh Choudhry (Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts), Robyn Gallagher (University of Sydney, Sydney, New South Wales, Australia), Tracy Glass (Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland), R. Brian Haynes (McMaster University, Hamilton, Ontario, Canada), Tiny Jaarsma (Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden, and Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia), Ashraf Kagee (Stellenbosch University, Stellenbosch, South Africa), Przemyslaw Kardas (Medical University of Lodz, Lodz, Poland), Jocelyne Moisan (Faculté de pharmacie de l'Université Laval and Centre de recherche du CHU de Québec-Université Laval, Laval, Québec, Canada), Donald Morisky (University of California, Los Angeles, Los Angeles, California), Andrew Mujugira (Makerere University School of Public Health, Kampala, Uganda, and University of Washington, Seattle, Washington), Phillip Newton (Western Sydney University, Sydney, New South Wales, Australia), Habib Omari (Kilimanjaro Christian Medical Center, Moshi, Tanzania), Lars Osterberg (Stanford University School of Medicine, Stanford, California), Cynthia Rand (Johns Hopkins School of Medicine, Baltimore, Maryland), Todd Ruppar (Rush University, Chicago, Illinois), Helady Sanders-Pinheiro (Federal University of Juiz de Fora, Juiz de Fora, Brazil), Eyal Schwartzberg (Pharmaceutical and Enforcement Divisions, Ministry of Health, Jerusalem, Israel; School of Pharmacy, Ben-Gurion University, Beer-Sheva, Israel; and Arnold and Marie Schwartz College of Pharmacy, Long Island University, Brooklyn, New York), Michael Stirratt (National Institute of Mental Health Division of AIDS Research, Rockville, and National Institutes of Health Adherence Research Network, Bethesda, Maryland), Liset van Dijk (Netherlands Institute for Health Services Research, Utrecht, the Netherlands), and Eric Van Ganse (Université Claude Bernard Lyon 1, Lyon University Hospitals, HESPER, and PELyon, Lyon, France). The authors also thank Chris Shultis for editing this paper.
Financial Support: Dr. Hughes is supported by the Medical Research Council North West Hub for Trials Methodology Research (MR/K025635/1). Dr. Zullig is supported by a Veterans Affairs Health Services Research and Development Career Development Award (CDA 13-025).
Disclosures: Dr. De Geest reports travel support from ESPACOMP during the conduct of the study. Dr. Zullig reports travel support from ESPACOMP during the conduct of the study. Prof. Hughes is member of the executive committee of ESPACOMP. Dr. Wilson reports consulting fees from Pfizer outside the submitted work. Dr. Vrijens reports that he is CEO of AARDEX Group. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at
Corresponding Author: Sabina De Geest, PhD, RN, Nursing Science, Department of Public Health, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland; e-mail, [email protected].
Current Author Addresses: Dr. De Geest and Mr. Helmy: Nursing Science, Department of Public Health, Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland.
Dr. Zullig: Department of Population Health Sciences, Duke University School of Medicine, 2200 West Main Street, Suite 720A, Durham, NC 27707.
Dr. Dunbar-Jacob: University of Pittsburgh School of Nursing, 3500 Victoria Street, Pittsburgh, PA 15261.
Prof. Hughes: Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor LL57 2PZ, Gwynedd, North Wales, United Kingdom.
Dr. Wilson: Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, G-S121-7, Providence, RI 02912.
Dr. Vrijens: AARDEX Group, Rue des Cyclistes Frontière 24, 4600 Visé, Belgium.
Author Contributions: Conception and design: S. De Geest, L.L. Zullig, R. Helmy, D.A. Hughes, I.B. Wilson, B. Vrijens.
Analysis and interpretation of the data: S. De Geest, L.L. Zullig, J. Dunbar-Jacob, R. Helmy, D.A. Hughes, I.B. Wilson, B. Vrijens.
Drafting of the article: S. De Geest, L.L. Zullig, J. Dunbar-Jacob, R. Helmy, I.B. Wilson, B. Vrijens.
Critical revision of the article for important intellectual content: S. De Geest, L.L. Zullig, R. Helmy, D.A. Hughes, I.B. Wilson, B. Vrijens.
Final approval of the article: S. De Geest, L.L. Zullig, J. Dunbar-Jacob, R. Helmy, D.A. Hughes, I.B. Wilson, B. Vrijens.
Provision of study materials or patients: S. De Geest.
Statistical expertise: S. De Geest, R. Helmy, B. Vrijens.
Obtaining of funding: S. De Geest, D.A. Hughes.
Administrative, technical, or logistic support: S. De Geest, R. Helmy, B. Vrijens.
Collection and assembly of data: S. De Geest, L.L. Zullig, R. Helmy, D.A. Hughes, I.B. Wilson, B. Vrijens.
This article was published at on 26 June 2018.
* Drs. Wilson and Vrijens share joint last authorship.

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Sabina De Geest, Leah L. Zullig, Jacqueline Dunbar-Jacob, et al. ESPACOMP Medication Adherence Reporting Guideline (EMERGE). Ann Intern Med.2018;169:30-35. [Epub 26 June 2018]. doi:10.7326/M18-0543

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