Development of an Item Bank to Measure Medication Adherence: Systematic Review

Abstract

Background Medication adherence is important in managing the progression of chronic diseases. A promising approach to reduce cognitive burden when measuring medication adherence lies in the use of computer‐adaptive tests (CATs) or in the development of shorter patient-reported outcome measures (PROMs). However, the lack of an item bank currently hampers this progress. Objective We aim to develop an item bank to measure general medication adherence. Methods Using the preferred reporting items for systematic review and meta-analysis (PRISMA), articles published before October 2019 were retrieved from PubMed, Embase, CINAHL, the Cochrane Library, and Web of Science. Items from existing PROMs were classified and selected (“binned” and “winnowed”) according to standards published by the Patient-Reported Outcomes Measurement Information System (PROMIS) Cooperative Group. Results A total of 126 unique PROMs were identified from 213 studies in 48 countries. Items from the literature review (47 PROMs with 579 items for which permission has been obtained) underwent binning and winnowing. This resulted in 421 candidate items (77 extent of adherence and 344 reasons for adherence). Conclusions We developed an item bank for measuring general medication adherence using items from validated PROMs. This will allow researchers to create new PROMs from selected items and provide the foundation to develop CATs.

Content validation of a new measure of patient-reported barriers to antiretroviral therapy adherence, the I-Score: results from a Delphi study

“…HIV-specific ART adherence barrier measures, on average, have covered approximately a third of subdomains of our conceptual framework and the involvement of patients in their development is reported for less than a third [ 13 ]. Items related to healthcare tend to be underrepresented in such instruments relative to those of other domains such as patient- and medication-related factors [ 13 , 21 ]. Indeed, in our previous work, we found over three-quarters of HIV-specific barrier measures reviewed included no item on the healthcare system or services [ 13 ].…”

“…Round 1 served to class items as: (1) “retained” items: consensus items to consider as core items of the measure; (2) “rejected” items; or (3) “undecided” items to be submitted to Round 2 of the Delphi for consideration as part of an item pool or bank, as done in other work on adherence measures [ 21 ]. An item was retained if at least 50% of PLHIV and 60% of providers rated it 3 (quite) or 4 (very) on both importance and actionability.…”

Do Community Free-Medication Service Policy Improve Patient Medication Adherence? A Cross-Sectional Study of Patients With Severe Mental Disorders in Beijing Community

“…The study's dependent variable is medication adherence, but there is no gold standard for judging it ( 26 ). There are hundreds of scales for measuring medication adherence in the previous literature ( 27 ) but considering that the energy of this type of special population is not enough to answer too many items, we use the 4-item Brooks Medication Adherence Scale ( 28 ) which have shown high levels of reliability (Cronbach's α = 0.78) and construct validity, meanwhile the measurement period is the past 12 months. This scale was used by Tamburrino et al in the study of medication adherence in patients with depressive disorder ( 29 ).…”