TABLE 1.

Continuum and components of adherence ⁷ , ¹⁰

Component of adherence	Description	Potential role for digital technology
Primary non‐adherence	When a patient never fills a prescription. A large retrospective study estimated that 28% of patients never filled a new prescription, with highest primary non‐adherence rates found for diabetic, anti‐hypertensives and lipid‐lowering drugs 53	Can be monitored through electronic prescribing with linkage to pharmacy dispensation data Minimal research into digital health strategies to improve primary non‐adherence
Initiation	When a patient begins taking a medication	Can be monitored through electronic pill boxes or other monitoring systems Minimal research into digital health strategies to improve initiation
Implementation (or execution)	When a patient takes a medication, often measured as the proportion of prescribed pills that are taken in a given time frame	Some demonstrated efficacy of text message programs, smartphone applications, and the use of the ‘internet of things’ to provide education and reminders that boost implementation and persistence of medication‐taking
Persistence	When a patient continues to take a medication continuously over longer intervals There is some evidence to suggest that approximately 40% of patients discontinue medications within 1 year 10
Discontinuation	When a patient stops taking a medication	Minimal research into digital health strategies to reduce discontinuation rates