"Replier Id","Instruction for the Delphi survey - part 2/Relevance","Instruction for the Delphi survey - part 2/Clarity","Instruction for the Delphi survey - part 2/Revisions of attribute labels and definitions","Instruction for the Delphi survey - part 2/Missing attributes in this group","Please provide some background information. It will be used only to describe the group of respondents and won't be linked to individual responses./Q1 Gender","Please provide some background information. It will be used only to describe the group of respondents and won't be linked to individual responses./Q2 Age","Please provide some background information. It will be used only to describe the group of respondents and won't be linked to individual responses./Q3 Country","Please provide some background information. It will be used only to describe the group of respondents and won't be linked to individual responses./Q4 EDUCATION LEVEL (highest achieved)","Please provide some background information. It will be used only to describe the group of respondents and won't be linked to individual responses./Q5 MAIN FIELD OF PROFESSIONAL EXPERTISE","Through which perspective are you answering today?/research/education professional","Through which perspective are you answering today?/healthcare practitioner","Through which perspective are you answering today?/policy/decision maker","Through which perspective are you answering today?/patient perspective","Through which perspective are you answering today?/e-Health/IT specialist","What is a ""medication adherence technology""?/Level of agreement","What is a ""medication adherence technology""?/Clarity","What is a ""medication adherence technology""?/Revision of the definition","What is a ""medication adherence technology""?/Other suggestions","Completeness of the proposed framework/argument","D1.1 Product and provider information/Relevance","D1.1 Product and provider information/Clarity","D1.1 Product and provider information/Revisions of attribute labels and definitions","D1.1 Product and provider information/Missing attributes in this group","D2.1 Target use scenario/Relevance","D2.1 Target use scenario/Clarity","D2.1 Target use scenario/Revisions of attribute labels and definitions","D2.1 Target use scenario/Missing attributes in this group","D2.2 Target health conditions/Relevance","D2.2 Target health conditions/Clarity","D2.2 Target health conditions/Revisions of attribute labels and definitions","D2.2 Target health conditions/Missing attributes in this group","D2.3. Medication regimen/Relevance","D2.3. Medication regimen/Clarity","D2.3. Medication regimen/Revisions of attribute labels and definitions","D2.3. Medication regimen/Missing attributes in this group","D2.4.1. Phase of medication adherence/Relevance","D2.4.1. Phase of medication adherence/Clarity","D2.4.1. Phase of medication adherence/argument","D2.4.2.A Monitoring/measurement type of management/Relevance","D2.4.2.A Monitoring/measurement type of management/Clarity","D2.4.2.A Monitoring/measurement type of management/Revisions of attribute labels and definitions","D2.4.2.A Monitoring/measurement type of management/Missing attributes in this group","D2.4.2.B Support/intervention type of management/Relevance","D2.4.2.B Support/intervention type of management/Clarity","D2.4.2.B Support/intervention type of management/Revisions of attribute labels and definitions","D2.4.2.B Support/intervention type of management/Missing attributes in this group","D2.4.2.B.1 Intervention modes of delivery/Relevance","D2.4.2.B.1 Intervention modes of delivery/Clarity","D2.4.2.B.1 Intervention modes of delivery/Revisions of attribute labels and definitions","D2.4.2.B.1 Intervention modes of delivery/Missing attributes in this group","D2.4.2.B.2 Target behaviour determinants /Relevance","D2.4.2.B.2 Target behaviour determinants /Clarity","D2.4.2.B.2 Target behaviour determinants /Revisions of attribute labels and definitions","D2.4.2.B.2 Target behaviour determinants /Missing attributes in this group","D2.4.2.B.3 Behaviour change techniques/Relevance","D2.4.2.B.3 Behaviour change techniques/Clarity","D2.4.2.B.3 Behaviour change techniques/Revisions of attribute labels and definitions","D2.4.2.B.3 Behaviour change techniques/Missing attributes in this group","D2.4.2.B.4 Intervention provider/Relevance","D2.4.2.B.4 Intervention provider/Clarity","D2.4.2.B.4 Intervention provider/Revisions of attribute labels and definitions","D2.4.2.B.4 Intervention provider/Missing attributes in this group","D2.4.2.B.5 Intervention setting /Relevance","D2.4.2.B.5 Intervention setting /Clarity","D2.4.2.B.5 Intervention setting /Revisions of attribute labels and definitions","D2.4.2.B.5 Intervention setting /Missing attributes in this group","D3.1.1.A ISO certification/Relevance","D3.1.1.A ISO certification/Clarity","D3.1.1.A ISO certification/Revisions of attribute labels and definitions","D3.1.1.A ISO certification/Missing attributes in this group","D3.1.1.B Evidence from scientific evaluation/Relevance","D3.1.1.B Evidence from scientific evaluation/Clarity","D3.1.1.B Evidence from scientific evaluation/Revisions of attribute labels and definitions","D3.1.1.B Evidence from scientific evaluation/Missing attributes in this group","D3.1.1.C Development standards/Relevance","D3.1.1.C Development standards/Clarity","D3.1.1.C Development standards/Revisions of attribute labels and definitions","D3.1.1.C Development standards/Missing attributes in this group","D3.1.1.D Technological standards/Relevance","D3.1.1.D Technological standards/Clarity","D3.1.1.D Technological standards/Revisions of attribute labels and definitions","D3.1.1.D Technological standards/Missing attributes in this group","D3.1.2 Research-related quality indicators/Relevance","D3.1.2 Research-related quality indicators/Clarity","D3.1.2 Research-related quality indicators/Revisions of attribute labels and definitions","D3.1.2 Research-related quality indicators/Missing attributes in this group","D3.1.3 Policy-related quality indicators/Relevance","D3.1.3 Policy-related quality indicators/Clarity","D3.1.3 Policy-related quality indicators/Revisions of attribute labels and definitions","D3.1.3 Policy-related quality indicators/Missing attributes in this group","D3.1.4 Use-related quality indicators/Relevance","D3.1.4 Use-related quality indicators/Clarity","D3.1.4 Use-related quality indicators/Revisions of attribute labels and definitions","D3.1.4 Use-related quality indicators/Missing attributes in this group","D3.2.1 Implementation outcomes/Relevance","D3.2.1 Implementation outcomes/Clarity","D3.2.1 Implementation outcomes/Revisions of attribute labels and definitions","D3.2.1 Implementation outcomes/Missing attributes in this group","D3.2.2 Implementation strategies/Relevance","D3.2.2 Implementation strategies/Clarity","D3.2.2 Implementation strategies/Revisions of attribute labels and definitions","D3.2.2 Implementation strategies/Missing attributes in this group"
"9c202dfab71567e6c5a1526236bfc6f2","","","","","","","Albania","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""
"26d5e0478dbf501cc100adffcba6acd9","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""
"f2ad57f077bc1821db2b70868bba2cca","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""
"40a2ecb47c6c2d4967ddd80d73e54d4d","4.776699029126213","4.97737556561086","","","Male","51-60","Belgium","Doctorate (PhD)","Data Science / Statistics ","","","","","20 to <30 years experience","1.0097087378640777","1.0135746606334841","""as agreed"" should be replaced by ""as prescribed"". As defined in the ABC taxonomy, the process of medication adherence starts with an appropriate prescription. There are thus two processes: 1) the process of prescription, and then followed by 2) the process of medication adherence.  The notion of agreement is key but is part of the prescription process. Therefore, it should not be included in the definition of ""medication adherence technologies""! This principle has been extensively discussed during the elaboration of the ABC taxonomy and should remain aligned to avoid confusion. ","","I am not able to open the documents & can thus not comment.","6.99360341151386","5.018036072144289","First, the ""product"" may be a combination of items (e.g. a device, an app, and a procedure to use it in care). Therefore, I would change the product definition into: ""Product is a device, procedure, system, or a combination thereof, ..."" Most of the time, I expect the product to be a combination.  Second, I see a potential issue with the label ""provider organization"", in particular for combination products. For example, in the case of a combination product (e.g. device + system), is the provider organization, the institution that puts the combination in place or the manufacturer of the device? This point should be crystal clear to avoid confusion.      ","","5.970149253731344","3.014028056112225","","","1.023454157782516","4.024048096192384","I am not convinced that this classification is relevant for medication adherence technologies.  Most cases will be confronted with multiple diseases. Cardiovascular is a mixed bag of many diseases ranging from benign conditions or preventive medicine to life-threatening ones.  Oncology is not on the list as such. From experience, I know that it is extremely hard to make sense of those categories in adherence research as they are more suited to uniquely classify medications. ","","6.9424307036247335","5.018036072144289","There are additional recommendations that need to be taken into account, like for example, with food, or without food. For injections or inhalation, there are more elements in the prescription: appropriate use of the injector, inhalation technique, etc.  I am not convinced that type of intention should be listed under the medication regimen. Sometimes it may be tricky! Finally, the Number of monitored medications is confusing in this list as there should be one dosing regimen for each medication.  ","","6.959488272921109","1.9879759519038078","Multiple imprecisions make this statement unclear. It should be a copy/paste of the ABC taxonomy paper. More specific:  1) this sentence is not clear: A medication adherence phase is a time interval between the prescription start and end dates that is behaviorally (i.e. linked with specific determinants and outcomes) and metrically (i.e. requires specific estimation methods) distinct. 2) In ""Discontinuation (Persistence) is the phase of adherence that refers to the end of treatment execution and covers the period until last dose is taken, e.g.  end of therapy or termination by patient. Persistence is the period between initiation and discontinuation."" the word execution should be implementation. Furthermore, this is not the defintion of discontinuation from ABC. 3) The process of ""adherence management"" has nothing to do in this sentence ""The definitions of adherence management are based on the ABC Taxonomy. For a more detailed view of the respective sub-levels with lables and definitions please check the interactive graph or the Excel file under supporting information."" I assume that it is a mistake?","7.0106609808102345","1.9719438877755513","This is a very important classification for future work but it is not yet mature as described here. I do not have a proposal that is better but here below some cases that highlight some gaps: 1) The notion of pill count needs to be extended to other delivery routes: weighting of returned cream in dermatology studies, mechanical/digital dose counter on some inhalers (without time stamping). 2) How do you classify prospective diaries? Is it self-reported by the patient? Do you make a difference if it is based on paper or through a smartphone (electronic method)?  3) How do you classify video recording of a dosing event (e.g. AIcure)? Is it DOT or electronic monitoring? Do you make a difference if an HCP is observing the ingestion by Skype? in real time or not?        At the least, I think that we need a category ""prospective diary"" in which we put all methods that require the patient to record the dosing event.  Seld-report being only retrospective?","","6.959488272921109","1.0100200400801604","This definition is key but very confusing as all changes are expected to go through determinants? Is this true?  Why don't we stick to the original ABC definition: Management of adherence is ""The process of monitoring and supporting patients’ adherence to medications by health care systems, providers, patients, and their social networks."" The objective of management of adherence is to achieve the best use by patients, of appropriately prescribed medicines, in order to maximize the potential for benefit and minimize the risk of harm.","","1.9786780383795308","2.0360721442885774","Not sure that this distinction is still relevant.  ","","4.963752665245202","1.9559118236472948","Here you pick the COM-B model, but the most widely used categorization of determinants is the WHO classification in 5 categories. It is much easier for HCPs in general. ","","6.99360341151386","5.034068136272545","I like it but it is conditional on COM-B model which is not widely known by every HCP....","","6.038379530916845","6.028056112224449","Should there be a category ""none""?","","2.9168443496801704","3.9759519038076157","","","5.953091684434968","6.060120240480962","Not sure why the MARS is referenced here. Most adherence technology vendors are coping with those standards. ","","5.9872068230277184","6.9579158316633265","","","5.9872068230277184","6.98997995991984","","","7.982942430703624","7.9839679358717435","","","5.9872068230277184","6.98997995991984","","","6.925373134328358","6.973947895791583","","","7.061833688699361","7.006012024048096","","","7.061833688699361","7.102204408817635","","","6.925373134328358","6.9579158316633265","",""
"019107ecbe557508ad449304fbd4ee43","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""
"e514d9ac0c614f467c5c8f901a44fb6b","2.183206106870229","4.332129963898916","","","Male","31-40","Latvia","Master","Economy / Management","","","less than 5 years experience","","","6.931297709923665","6.180505415162455","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""
"9693742e95befe78f58a0f06dcaddab5","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""
"f0d32cf77a38c457f1be96885face8a5","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""
"528d2665fd414ec8fe1d6283fc7331e1","","","","","Male","51-60","France","Master","Economy / Management","15 to <20 years experience","","","","20 to <30 years experience","7.417935702199662","7.355877616747182","","While we are clearly talking about medication adherence, and as such it is fitting that we restrict ourselves to this, it may be pertinent as well to consider adherence to healthcare recommendations that are not strictly about medication adherence.  For example, changes in lifestyle.","Note that I am not able to open the support documents, as such, my comments may be obviated by what they contain.  On the basis of the above diagram, though, I would say this is extremely complete.  Some additional factors may be: - Patient type.  While most interventions are for all patients with a given situation, some may be specific: i.e. only for children, or in HIV only for drug users, although the actual indication may be appropriate for a broader patient definition.  Still others might not actually be targeted at patients at all, but rather to their caregivers. - Legislative category.  Notably, some may want to sort only for MATechs with authorisation as medical devices / DTX status in a given country - Geographic scope","7.241962774957699","5.758454106280193","","","7.83756345177665","5.475040257648953","","","5.739424703891709","5.475040257648953","I wonder if there shouldn't be a specific category for vaccines.  While we're not talking about a chronic condition, adherence in vaccine mandates or suggestions is an (increasingly pertinent) topic.  Furthermore, in the case of vaccines that require multiple doses, such as most covid vaccines, as well as HPV, drop-off between injections is a serious issue.","","4.818950930626057","5.075684380032206","I would include consideration of whether the patient has self-dosing to take into account, such as with fast insulin, rescue therapies in asthma or AVK medications.","","5.9424703891708965","2.421900161030596","","7.120135363790186","3.723027375201288","I'm not sure whether this is best addressed here or elsewhere, but I think we should also know what exact measure is being determined.  I assume it's going to be PDC, but in some cases it will be MPR... and even for PDC are they measuring simply, for example, whether someone took the medication on a given day, or whether they took it at the right time, in the right circumstances (e.g. with a meal when so requested)?  I also think that we would need to elaborate more the second part, the measurement target.  I doubt that many people behind interventions will be entirely at ease with the sentence ""measurement targeting causal influences on the behaviour that can be modifiable""","","4.67005076142132","1.0177133655394526","I'm actually still not sure what this is supposed to mean.  What is the difference between support and intervention?  How can you support a patient without intervening in some way?  I can imagine an attribute that addresses the specificities of what is being supported, i.e. access to medication / financial support vs. attitudinal changes or coaching, but otherwise this is unclear to me.","","5.387478849407783","6.041867954911433","I think we should specify in the case of human interaction exactly which humans are interacting.  Notably, there are interventions that are designed exclusively to provide guidance to healthcare professionals as to how to interact with patients so as to affect adherence.  Some target physicians, others nurses, others pharmacists, and some deal with other HCPs, such as physical therapists.  I think that this is very different from interventions that, for example, aim to build patient support groups.","","7.174280879864636","7.2270531400966185","","","5.116751269035533","4.289855072463768","I love the list of BCTs and the efforts around them.  At the same time, many interventions are explicitly built around ideas coming more from behavioral economics (notably, Kahneman or Thaler) which might be a little more difficult to classify according to the BCT work.  Even moreso, many interventions are quite purposefully built around CBT, including concepts from motivational interviewing.  These can be viewed through the COM-B framework, notably with respect to motivation, but it would be nice to be able to quickly identify those interventions that use these approaches.  For example, a number of mental health programs in the United States have received Class II authorisation largely because they are explicitly built on CBT, which has solid evidence for impact in depression.","","7.025380710659898","4.7407407407407405","I think we're definitely missing a category for self-enrolment programs.  Many apps and programs are not presented by anyone, the patient themselves enrol, and as such, the patient is the ""intervention provider"".  In many other cases, an HCP may enrol a patient, but their involvement in the intervention stops there, which is different from them having an active role.","","7.688663282571912","7.626409017713366","There should clearly be the possibility of having ""both"".  Many such ""hybrid"" programs exist.","","2.436548223350254","7.819645732689211","","","7.404399323181049","7.458937198067633","","","5.752961082910321","6.183574879227053","","","4.99492385786802","7.1368760064412236","I think that the relevance of data protection is greater than the other three factors.  All are important, but there have been effective programs that all the same had issues with platform compatability, or a few bugs, but data privacy is a serious ethical and legislative factor that bears no errors.","","7.363790186125211","7.059581320450886","","","5.170896785109983","6.415458937198068","","","5.455160744500846","6.144927536231884","","","7.323181049069374","7.214170692431562","This is obviously crucial","","7.255499153976311","7.239935587761675","",""
"a22a19c64713191b26538ab44524f668","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""
"6dd2dda8dc111e3de2b5954fe3e41fe1","4.012269938650307","4.023460410557185","","","Male","31-40","Spain","Doctorate (PhD)","Computer Science / Software Engineering","5 to <10 years experience","","less than 5 years experience","less than 5 years experience","10 to <15 years experience","7.067484662576687","6.768328445747801","","","","6.9447852760736195","5.302052785923754","","","6.601226993865031","5.055718475073314","","","5.067484662576687","4.668621700879765","","","6.993865030674846","4.5630498533724335","","","5.742331288343558","1.900293255131965","","6.6871165644171775","3.2023460410557183","","","6.03680981595092","1.712609970674487","","","6.306748466257669","4.574780058651026","","","6.441717791411043","5.935483870967742","","","6.625766871165644","4.39882697947214","","","6.098159509202454","5.736070381231672","","","4.809815950920245","6.510263929618768","","","5.47239263803681","5.337243401759531","","","6.993865030674846","6.81524926686217","","","6.9815950920245395","6.604105571847507","","","6.343558282208589","7.167155425219941","","","6.822085889570552","7.178885630498534","","","6.404907975460123","6.909090909090909","","","7.460122699386503","7.249266862170088","","","7.411042944785276","7.0498533724340176","","","6.969325153374233","6.885630498533724","",""
"6645068e6f232fb2910d10c5b81c7d09","","","","","Female","41-50","Italy","Doctorate (PhD)","Pharmacy","15 to <20 years experience","","","","","7.296416938110749","6.198757763975156","","","","6.5667752442996745","5.0310559006211175","","","6.514657980456026","4.39751552795031","","","5.003257328990228","5.51552795031056","","","6.267100977198697","5.055900621118012","","","6.801302931596092","3.0434782608695654","","6.1107491856677525","3.6024844720496896","","","5.96742671009772","2.062111801242236","","","6.006514657980456","2.9813664596273295","","","6.996742671009772","6.037267080745342","","","5.602605863192182","4.447204968944099","","","6.045602605863192","5.043478260869565","","","","","","","5.0814332247557","4.9813664596273295","","","7.687296416938111","7.0310559006211175","","","5.96742671009772","6.086956521739131","","","4.690553745928339","7.043478260869565","","","5.58957654723127","6.931677018633541","","","5.537459283387622","6.111801242236025","","","7.04885993485342","7.0062111801242235","","","6.98371335504886","7.37888198757764","","","7.087947882736156","7.15527950310559","",""
"8366ab2242baa33fac722d5544e9c7f0","","","","","Female","61-70","United Kingdom ","Doctorate (PhD)","Medicine","20 to <30 years experience","more than 30 years experience","","","10 to <15 years experience","6.846625766871166","6.897360703812317","","","","7.815950920245399","5.712609970674487","","","7.226993865030675","4.997067448680352","The phrase in brackets is not completely clear.  Maybe change to (i.e. for self-management, adherence or to support service use)","","5.435582822085889","4.0","These are all disease categories, but the heading is about 'health conditions'.  There is a tendency to use 'health' as a euphemism for 'disease' (as in national Health Service!) ","","6.404907975460123","4.0","This feels very rigid - and sometimes that is appropriate - but there are drugs that are used 'as required', or for which self-management action plans enable the patient to adjust their dosage.   This needs to be possible within the form","","5.58282208588957","1.1964809384164221","","6.9815950920245395","4.410557184750733","","","6.7975460122699385","4.0469208211143695","","","7.411042944785276","6.979472140762463","","","6.7607361963190185","6.357771260997067","","","6.773006134969325","6.310850439882698","","","6.858895705521473","5.466275659824047","","","4.993865030674846","7.671554252199414","","","6.294478527607362","5.008797653958944","","","7.374233128834356","7.460410557184751","I would say this is crucial","","6.588957055214724","6.545454545454545","","","6.969325153374233","6.967741935483871","","","6.539877300613497","6.86217008797654","","","6.49079754601227","6.545454545454545","","","7.300613496932515","7.730205278592376","It won't be used if it is not liked!","","7.766871165644171","6.674486803519062","","","7.006134969325154","5.947214076246334","",""
