Adaption and validation of the adherence barriers questionnaire for HIV patients on antiretroviral therapy (ABQ-HIV)

Mueller, Sebastian; Wilke, Thomas; Gorasso, Vanessa; Erhart, Marc; Kittner, Jens M.

doi:10.1186/s12879-018-3530-x

Cited by 17 publications

(19 citation statements)

References 24 publications

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“…No subscales were identified. Previous versions of the ABQ could be divided into subscales of intentional, unintentional, and medication/healthcare system-related barriers [ 25 , 26 ]. However, anti-VEGF therapy with regular injections poses specific challenges to DME/nAMD patients in terms of travel and interference with daily life (e.g., eyesight difficulties after injection) [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…The "Adherence Barriers Questionnaire" (ABQ) is an instrument originally developed by Müller et al . to elicit barriers to treatment adherence in atrial fibrillation [ 24 , 25 ] and has been adapted to assess adherence in several other indications such as human immunodeficiency virus and chronic obstructive pulmonary disease [ 26 , 27 ]. The ABQ and its adaptations have been shown to be practical, reliable, and valid instruments to elicit barriers to treatment adherence in chronic indications with self-administered medication.…”

Section: Introductionmentioning

confidence: 99%

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Questionnaire for the assessment of adherence barriers of intravitreal therapy: the ABQ-IVT

et al. 2021

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Objective To develop and validate a questionnaire for the investigation of non-adherence (NA) barriers in patients receiving intravitreal injection (IVT). Design Questionnaire development and cross-sectional patient survey combined with a retrospective medical chart review. Participants German patients with neovascular age-related macular degeneration (nAMD) or diabetic macular edema (DME) receiving anti-vascular endothelial growth factor (anti-VEGF) treatment via IVT. Methods The previously validated (indications: atrial fibrillation, human immunodeficiency virus, chronic inflammatory lung disease) Adherence Barriers Questionnaire (ABQ) was revised according to specifications of IVT, within the framework of an expert panel. The ABQ-IVT, which initially consisted of 24 items formulated as statements (4-point-Likert-scale ranging from “strongly agree” to “strongly disagree”), was applied in a cross-sectional survey. Evaluation of the questionnaire included an assessment of internal consistency and factor analysis. The occurrence of potential barriers in the patient sample was evaluated using descriptive statistics. To identify patient subpopulations, hierarchical cluster analysis was performed using ABQ-IVT answers as predictors. Due to difficulties in capturing NA as an external criterion, the evaluation of the questionnaire was limited to its internal validity and reliability. Main outcome measures Patients’ answers to the ABQ-IVT questionnaire and interviews. Results Of 253 patients, 234 (92%) were able to complete the ABQ-IVT questionnaire. Within the reliability analysis, the ABQ-IVT was reduced to 17 items. The condensed questionnaire demonstrated good internal consistency (Cronbach’s alpha = 0.78), and factor analysis showed no evidence for subscales of the questionnaire. Nearly half of the patients (49%) reported being affected by at least three different barriers. On average, a patient was affected by 3.1 barriers. The most frequently reported barriers were “Challenge due to time commitment of physician visits” (45% of the patients), “Depression” (29%) and “Travel and opportunity costs” (27%). Cluster analysis identified six patient subpopulations, each affected by different sets of barriers and differed regarding their patient characteristics. Conclusions The ABQ-IVT is a practical and reliable instrument for identifying patient-specific barriers to IVT treatment adherence. In practice, the questionnaire may be useful in assessing whether individual patients are at higher risk of NA due to specific adherence barriers. Aside from better awareness, this allows earlier interventions, though these still need to be validated. Patient subpopulations face different barriers and may, therefore, need distinct preventative care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Questionnaire for the assessment of adherence barriers of intravitreal therapy: the ABQ-IVT

et al. 2021

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“…After approximately 9 months, patients completed the ABQ-Asthma through computer-assisted phone interviews conducted by trained interviewers. The ABQ is a validated instrument that has already been shown to be a practical, reliable, and valid questionnaire to assess adherence barriers in chronic indications [ 18 , 19 ]. Developed initially in indications with orally applied treatments, the ABQ was adapted to the specific needs of inhaled medications [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

Identifying the Causes Increasing the Risk of Non-Adherence in Adult Patients with Asthma: An Analysis Combining Patient Survey Data with German Claims Data

Müller

Maywald²,

Timmermann³

et al. 2021

Drugs - Real World Outcomes

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Background There exists a range of treatments in the management of asthma. Non-adherence to these medications has been identified as a factor negatively impacting the effects of treatment. Objective The objective of this study was to identify the potential barriers to medication adherence among adult patients with asthma in Germany. Patients and Methods A multi-center observational study was conducted addressing adult patients with asthma who were prescribed regular maintenance medication between 2014 and 2016. Data were derived from physicians’ documentation as well as claims data, which were linked to the above primary observational data, and patient survey data. Adherence barriers were assessed by the validated Adherence Barriers Questionnaire, both descriptively and in a logistic regression framework. Cluster analysis identified distinct patient groups with respect to the relevance of specific adherence barriers. Results We included 524 patients with asthma (mean age 53.1 years, 74.6% female, 43.1% allergic asthma, 37.6% nonallergic, 19.3% mixed). Most of the participants reported to face at least three barriers (61.1%). Frequently reported barriers were the perception that medications are all harmful (53.6% of the participants), the burden of medication co-payment (44.1%), positive perception about current health status (39.9%), feeling of depression (30.9%), and the fear of side effects (27.5%). Four distinct patient clusters could be identified: cluster 1 with a low number of barriers (28.6% of participants), cluster 2 (11.6%) with a comparably high number of existing barriers, cluster 3 with high importance of depression as a barrier (27.3% of participants), and cluster 4 that was dominated by the perception that medications are all harmful (32.5% of participants). Conclusions Results of this study provide important insights for further development of adherence programs, which should focus on distinct patients’ clusters that differ substantially in the relevance of specific adherence barriers.

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“…6 Therefore, direct engagement with patients is crucial to address any "adherence barriers." 3,7 Nevertheless, in real-world treatment settings, systematic interventions to measure and improve patients' adherence are rarely used. 8,9 For example, the Global Asthma Physician Survey (GAPS) estimated that written action plans (37%) and technology (15%) were rarely employed by physicians to aid patients' asthma management.…”

Section: Introductionmentioning

confidence: 99%

<p>How to Implement Adherence-Promoting Programs in Clinical Practice? A Discrete Choice Experiment on Physicians’ Preferences</p>

Müller

Ziemssen

Diehm

et al. 2020

PPA

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The aim of this study was to examine physicians' preferences regarding adherence-promoting programs (APPs), and to investigate which APP characteristics influence the willingness of physicians to implement these in daily practice. Materials and Methods: A discrete choice experiment was conducted among general practitioners, cardiologists, neurologists and ophthalmologists in Germany. The design considered five attributes with two or three attribute levels each: validation status of the APP; possibility for physicians to receive a certificate; type of intervention; time commitment per patient and quarter of the year to carry out the APP; reimbursement for APP participation, per included patient and quarter of the year. A multinomial logit model was run to estimate physicians' utility for each attribute and to evaluate the influence of different levels on the probability of choosing a specific APP. The relative importance of the attributes was compared between different predefined subgroups. Results: In total, 222 physicians were included in the analysis. The most important characteristics of APPs were time commitment to carry out the program (34.8% importance), reimbursement (33.3%), and validation status of the program (23.7%). The remaining attributes (type of intervention: 3.6%; possibility to receive a certificate: 4.7%) were proven to be less important for a physician's decision to participate in an APP. Physicians on average preferred APP alternatives characterized by little time commitment (β=1.456, p<0.001), high reimbursement for work (β=1.392, p<0.001), "positive validation status" (β=0.990, p<0.001), the "possibility to get a certificate" (β=0.197, p<0.001), and the provision of "tools for both physicians and patients" (β=0.150, p<0.001). Conclusion: For the majority of the physicians participating in this survey, the willingness to implement an APP is determined by the associated time commitment and reimbursement. Considering physicians' preferences regarding different APP features in the promoting process of these programs may enhance physicians' participation and engagement.

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Adaption and validation of the adherence barriers questionnaire for HIV patients on antiretroviral therapy (ABQ-HIV)

Cited by 17 publications

References 24 publications

Questionnaire for the assessment of adherence barriers of intravitreal therapy: the ABQ-IVT

Questionnaire for the assessment of adherence barriers of intravitreal therapy: the ABQ-IVT

Identifying the Causes Increasing the Risk of Non-Adherence in Adult Patients with Asthma: An Analysis Combining Patient Survey Data with German Claims Data

<p>How to Implement Adherence-Promoting Programs in Clinical Practice? A Discrete Choice Experiment on Physicians’ Preferences</p>

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