Electronic Monitoring of Adherence in Clinical Care: Ethical and Practical Considerations

Objective:Adherence to prescribed medical regimens is a key behavior for managing disease burden and progression. Despite the importance of understanding a child’s adherence, many evidence-based assessment strategies have not been implemented into subspecialty clinical practice. The aim of this article was to highlight the potential ethical and regulatory challenges of using electronic monitoring (EM) of adherence in clinical care and offer practical solutions. Methods:Relevant ethical and legal standards were researched and summarized as applicable to EM of adherence. Results:Issues related to Human Relations, Privacy and Confidentiality, Record Keeping, and Assessment all apply to EM of adherence. Conclusions:Clinicians should be mindful and seek to proactively address issues related to informed consent, autonomy, privacy, and equity before starting an EM program of adherence. Multidisciplinary teams should thoroughly consider the ethical and legal aspects of implementing this form of adherence assessment into clinical practice.Implications for Impact Statement This topical review is the first to describe the practical implications of utilizing electronic monitoring of adherence in a clinical care setting with a multidisciplinary medical team. This is an important reference for any pediatric psychologist or practitioner who wants to be fully informed about the potential ethical and legal ramifications of using this technology with youth.