Newspaper headline: What I say is not what I do. Health research suggests that what people say they do, does not match what they actually do. This could negatively affect recovery from illness. Roth and Caron (1978) found that objective biochemical tests revealed that people were taking medicine less often than they said they were.

Mark scheme

Marking points from the official mark scheme (May/June 2019). The mark or mark type is shown in brackets.

1. Most likely answer (other appropriate responses to be credited):
2. Objective is fact, a measure that cannot be disputed; subjective is more anecdotal (e.g. where people say they have taken medicine)
3. For example, if a drug is detected in blood or urine then it is an objective fact.
4. Marks: 1 mark for basic answer. 1 mark for elaboration / example.
5. Note: 1 mark max. if 'objective' is defined without reference to adherence.
6. Most likely answer (other appropriate responses to be credited):
7. Urine sample: e.g. Gordis et al. found that of 103 children who should have been taking penicillin a urine test revealed only 42% were compliant despite 73% of mothers claiming they had given it to their children. Willcox et al. found when analysing a urine sample only 31% were taking medication as prescribed.
8. Blood test: e.g. analysis of a blood sample can reveal objectively whether any medication has been taken or not. This could be any form of pill, etc.
9. Marks: 1 mark identification 2 marks detail of test OR detail of relevant study x 2.
10. Note: 'salivary cortisol' = 0 marks. Cortisol is a stress-related hormone.
11. Most likely answer (other appropriate responses to be credited):
12. Repeat prescriptions (Sherman et al., 2000) obtaining repeat prescriptions and analysing without patient's knowledge. Assumption is that if prescription repeated the original must have been used.
13. Pill counting (Chung and Naya, 2000) using trackcap or other devise to record number of pills (assumed to have been taken).
14. Marks: 1 mark basic answer (e.g. identification of measure), 2 marks detailed answer / elaboration × 2.
15. Note: biochemical tests (Roth and Caron, 1978) scores zero marks (see stem)
16. Marks: Question requires discussion; always plural of each argument, and always requires conclusion.
17. 1 mark for each advantage / disadvantage (however detailed) and related to the question up to 4 max. 2 marks max. for two strengths / weaknesses unrelated to the question. 1 mark for conclusion.
18. Most likely answer (other appropriate responses to be credited):
19. Advantages:
20. Provides objective ('factual') data.
21. Test is reliable (same test repeated on every person)
22. Test is valid (measures substance 'x')
23. Disadvantages:
24. Biochemical methods do not measure the degree of adherence; the presence of a drug or drug marker merely reveals that the patient ingested some amount of the drug at some time and does not indicate that the patient took the proper amount at the proper time.
25. There are individual differences in the absorption and metabolism of drugs and this can lead to variations in recordings of people who are equally compliant.
26. Biomedical checks are much more expensive than any other method so why would expensive tests be conducted to determine levels of non-adherence
27. Conclusion: any appropriate conclusion drawn from the discussion that has been presented. 1 mark if appropriate. A conclusion is a 'decision reached by reasoning' and so a summary of points already made scores 0 marks.