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ESPACOMP Medication Adherence Reporting Guidelines (EMERGE)


EMERGE is an initiative taken by a working group (EMERGE steering committee) of members of the European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) to develop guidelines for reporting quantitative studies of medication adherence. EMERGE are meant to be an addition to the existing guidelines for health research reporting such as STROBE, CONSORT, STaRI, CHEERS and TIDier guidelines (EMERGE Items List).


The guidelines were developed using the ABC taxonomy for medication adherence as the conceptual basis. An initial item list was developed by the EMERGE steering committee through an iterative process (i.e. an in-person meeting for initial item generation followed by structured review rounds via email and conference calls) followed by 2 Delphi rounds with 26 international adherence experts from 15 countries and from different disciplines.


EMERGE consists of 21 items organized in 2 sections: the first section includes 4 items reflecting the conceptualization of medication adherence as put forward by the ABC taxonomy for medication adherence. These items represent the minimum reporting criteria that are considered crucial to be reported in each publication, regardless of the format of the publication, in order for medication adherence research to advance benefiting from the conceptualization provided by the ABC  taxonomy.

The second section consists of 17 items specific to medication adherence reporting and organized in a way congruent with the sections of reporting guidelines for observational and experimental study types (i.e. STROBE and CONSORT). Redundancy with existing guidelines has been avoided by only including items that are specific to medication adherence. Authors therefore will need to use the main reporting guidelines for their study type (e.g. STROBE and CONSORT) and combine these with EMERGE. Items included in EMERGE are thus applicable to different types of methodologies.

We hope that the implementation of the ESPACOMP Medication Adherence Reporting Guidelines (EMERGE) will enhance the quality of reporting relevant aspects of medication adherence research in a standard manner and ultimately advance the adherence field towards achieving its ultimate goal of improved  outcomes.


The EMERGE steering committee:
Sabina De Geest1, PhD, RN; Leah L. Zullig2, PhD, MPH; Jackie Dunbar-Jacob3, PhD, RN; Dyfrig Hughes4, MRPharmS, PhD;  Ira B. Wilson5, MD, PhD, Bernard Vrijens6, PhD.


1 University of Basel, Basel, Switzerland, and Academic Centre for Nursing and Midwifery, KU-Leuven, Leuven, Belgium
2 Durham Centre of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) and Duke Department of Population Health Sciences, Durham, North Carolina
3 University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania
4 Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, Gwynedd, North Wales, United Kingdom
5 Brown University School of Public Health, Providence, Rhode Island
6 University of Liège, Liège, Belgium, and AARDEX Group, Liège, Belgium

For more information , please contact us at:;

EMERGE Publications

EMERGE Annals of Internal Medicine   
De Geest S, Zullig LL, Dunbar-Jacob J, Helmy R, Hughes DA, Wilson IB, Vrijens B. ESPACOMP Medication Adherence Reporting Guideline (EMERGE). Ann Intern Med. 2018 Jul 3;169(1):30-35. doi: 10.7326/M18-0543.


EMERGE study protocol  
Helmy R, Dunbar-Jacob J, Hughes D, Vrijens B, Wilson IB, Zullig LL, De Geest S. ESPACOMP Medication Adherence Reporting Guidelines (EMERGE): a reactive-Delphi study protocol. BMJ Open, 2017, 
7(2):e013496. doi: 10.1136/bmjopen-2016-013496


EMERGE is listed on the EQUATOR network and has been disseminated through peer-reviewed publications, social media and websites.

Zullig L, De Geest S. Ask About Adherence: Taking adherence research to a global level.


Papers on EMERGE

Ask About Adherence: Taking adherence research to a global level

Zullig et al.


Research papers using EMERGE

van der Laan DM, Elders PJM, Boons CCLM, Nijpels G, van Dijk L, Hugtenburg JG. Effectiveness of a Patient-Tailored, Pharmacist-Led Intervention Program to Enhance Adherence to Antihypertensive Medication: The CATI Study. Front Pharmacol. 2018 Sep 26;9:1057. doi: 10.3389/fphar.2018.01057. eCollection 2018.



Date meeting
2017-01-19 → 2017-01-19