Ethical considerations in adherence research

Figures & data

Table 1 Advantages and disadvantages of different forms of adherence monitoring disclosure

Type of disclosure	Full disclosure	Authorized deception	Withholding	Stealth
Definition	Informed consent Complete explanation of methods of adherence monitoring	Informed consent with no details about exact monitoring procedure Full disclosure at the end of participation	Acknowledgment of and consent for monitoring is obtained only at the conclusion of the study	Not aware of being in the study at all
Advantages	Minimizes the risk of psychological effects Preserves participant autonomy	Reduces the impact of monitoring on subjects’ adherence behavior	Adherence data are unaffected by Hawthorne effects	Closest representation of clinical experience Best data to analyze patient behaviors
Drawbacks	May interfere with normal adherence behavior and therefore may not reflect true clinical experiences	Requires a degree of deception and adherence data may be biased	If subjects are permitted to drop out, biased adherence data may be obtained	Highest risk of mistrust and loss of participant autonomy