Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties

Koschack, Janka; Marx, Gabriella; Schnakenberg, Jörg; Kochen, Michael M.; Himmel, Wolfgang

doi:10.1016/j.jclinepi.2009.06.011

Cited by 75 publications

(73 citation statements)

References 30 publications

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“…Outra limitação do trabalho refere-se à escala utilizada para mensuração do desfecho, que em publicações recentes tem sido apontada como desempenho variável 6,43,44 , podendo levar a imprecisões na discriminação da adesão/não adesão. É preciso considerar, todavia, que não há consenso sobre um método para avaliar a adesão que possa ser tomado como padrão-ouro e que a forma de avaliar a adesão deve considerar os recursos disponíveis e obedecer a normas psicométricas básicas 21,45 .…”

Section: Discussionunclassified

Não adesão ao tratamento medicamentoso contínuo: prevalência e determinantes em adultos de 40 anos e mais

2014

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O presente estudo investiga os fatores associados a não adesão à terapia medicamentosa contínua em indivíduos de 40 anos e mais de idade. Foi realizado um inquérito de base populacional em Cambé, Paraná, Brasil. A adesão à terapia foi avaliada pela escala de quatro itens de Morisky et al. e analisaram-se também variáveis sociodemográficas, de utilização dos serviços de saúde e do uso de medicamentos. Foram entrevistados 1.180 indivíduos, dos quais 78% utilizaram medicamentos nos 15 dias anteriores à entrevista e em 55% registrou-se o uso contínuo. A amostra do estudo consistiu em 639 indivíduos, com predominância do sexo feminino, idade entre 40 e 59 anos, baixa escolaridade. A prevalência de não adesão foi de 63,5%. Após análise ajustada, permaneceram associados a não adesão: não ser acompanhado pelo agente comunitário de saúde, ter tido descontinuidade no acesso aos medicamentos e a elevada frequência de utilização dos medicamentos ao longo do dia. Os resultados indicam uma alta prevalência da não adesão com possíveis impactos negativos para os indivíduos e para a sociedade.

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Section: Discussionunclassified

Não adesão ao tratamento medicamentoso contínuo: prevalência e determinantes em adultos de 40 anos e mais

2014

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“…For example, hypertension studies report associations between blood pressure and various self-report measures of antihypertensive medication adherence that range from very weak [50] to a modest yet statistically significant relationship [51,52]. In type 2 diabetes, few studies have tested the relationship between glycemic control and self-report of medication adherence [2].…”

Section: Validity Of Medication Adherence Self-reportsmentioning

confidence: 99%

Self-report measures of medication adherence behavior: recommendations on optimal use

Stirratt

Dunbar‐Jacob

Crane

et al. 2015

Behav. Med. Pract. Policy Res.

605

528

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Medication adherence plays an important role in optimizing the outcomes of many treatment and preventive regimens in chronic illness. Self-report is the most common method for assessing adherence behavior in research and clinical care, but there are questions about its validity and precision. The NIH Adherence Network assembled a panel of adherence research experts working across various chronic illnesses to review selfreport medication adherence measures and research on their validity. Self-report medication adherence measures vary substantially in their question phrasing, recall periods, and response items. Self-reports tend to overestimate adherence behavior compared with other assessment methods and generally have high specificity but low sensitivity. Most evidence indicates that self-report adherence measures show moderate correspondence to other adherence measures and can significantly predict clinical outcomes. The quality of self-report adherence measures may be enhanced through efforts to use validated scales, assess the proper construct, improve estimation, facilitate recall, reduce social desirability bias, and employ technologic delivery. Self-report medication adherence measures can provide actionable information despite their limitations. They are preferred when speed, efficiency, and low-cost measures are required, as is often the case in clinical care. KeywordsAdherence, Compliance, Self-management, Medication, Self-report Valid measurement of medication adherence plays a crucial role in healthcare and health research. When a patient is not benefiting from a medication regimen, clinicians need sound adherence information to determine whether the medication is ineffective or not being taken as prescribed. Assessing medication adherence during routine clinical care can further ensure that individuals in need of adherence support interventions receive them, ideally before deleterious outcomes occur. In the context of clinical research, proper interpretation of proof-of-concept trials testing new pharmacologic regimens requires valid adherence data, because any null findings may stem from poor adherence rather than a lack of drug efficacy. Research designed to understand and promote medication adherence also requires precise methods of adherence assessment.Among many approaches to assessing medication adherence, patient self-report measures remain the most common method [1][2][3][4][5][6]. These measures are defined by asking respondents to characterize their medication adherence behavior. Self-report measures of medication adherence range from simple singleitem questions regarding missed doses to complex multi-item assessments that incorporate reasons for nonadherence [7]. The widespread use of self-report adherence measures in clinical care and research reflects their low cost and ease of implementation across a large variety of medication regimens.There are two primary challenges related to selfreport measures of medication adherence. ImplicationsPractice: Routine assessment of medication...

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“…The minimal variation and relatively high rates of self-management reported when the Hill-Bone measurement instrument was administered to our study population at baseline, combined with the findings of two subsequent publications about the psychometric properties of the Hill-Bone [24,25], suggest that the tool may not be an ideal research instrument. The current literature indicates that about 50% of patients traditionally classified with resistant hypertension are effectively nonadherent [26,27].…”

Section: Discussionmentioning

confidence: 81%

Home-based interventions for black patients with uncontrolled hypertension: a cluster randomized controlled trial

et al. 2016

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Aim: Assess the comparative effectiveness of two blood pressure (BP) control interventions for black patients with uncontrolled hypertension. Patients & methods: A total of 845 patients were enrolled in a three-arm cluster randomized trial. On admission of an eligible patient, field nurses were randomized to usual care, a basic or augmented intervention. Results: Across study arms there were no significant 12 months differences in BP control rates (primary outcome) (25% usual care, 26% basic intervention, 22% augmented intervention); systolic BP (143.8 millimeters of mercury [mmHg], 146.9 mmHG, 143.9 mmHG, respectively); medication intensification (47, 43, 54%, respectively); or self-management score (18.7, 18.7, 17.9, respectively). Adjusted systolic BP dropped more than 10 mmHg from baseline to 12 months (155.5-145.4 mmHg) among all study participants. Conclusion: Neither the augmented nor basic intervention was more effective than usual care in improving BP control, systolic BP, medication intensification or patient self-management. Usual home care yielded substantial improvements, creating a high comparative effectiveness threshold. Clinical Trial Registration: NCT00139490.

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Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties

Cited by 75 publications

References 30 publications

Não adesão ao tratamento medicamentoso contínuo: prevalência e determinantes em adultos de 40 anos e mais

Não adesão ao tratamento medicamentoso contínuo: prevalência e determinantes em adultos de 40 anos e mais

Self-report measures of medication adherence behavior: recommendations on optimal use

Home-based interventions for black patients with uncontrolled hypertension: a cluster randomized controlled trial

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