Finalization and Validation of Questionnaire and Algorithm of SPUR, a New Adherence Profiling Tool

Abstract

Purpose The SPUR (Social, Psychological, Usage and Rational) Adherence Profiling Tool is a recently developed adaptive instrument for assessing key patient-level drivers for non-adherence. This study describes the SPUR questionnaire’s finalization and psychometric evaluation. Patients and Methods Data were collected through an online survey among patients with type 2 diabetes included by general practitioners and diabetologists in France. The survey included four questionnaires, SPUR and three validated adherence measures: BMQ, MARS and ACCEPT. Item-level analysis and a partial credit model (PCM) were performed to refine the response option coding of SPUR items. The final item selection of SPUR was defined using a PCM and a principal component analysis (PCA). Construct validity, concurrent validity and known-groups validity were assessed on the final SPUR questionnaire. Results A total of 245 patients (55% men, mean age of 63 years) completed the survey remotely and were included in this analysis. Refining response option coding allowed a better discrimination of patients on the latent trait. After item selection, a short, an intermediate, and a long form composed the final SPUR questionnaire. The short form will be used to screen patients for risk and then the other forms will allow the collection of further information to refine the risk assessment and decide the best levers for action. Results obtained were supportive of the construct validity of the forms. Their concurrent validity was demonstrated: moderate to high significant correlations were obtained with BMQ, MARS and ACCEPT scores. Their known-groups validity were shown with a logical pattern of higher scores obtained for patients considered non-adherent and significant differences between the scores obtained for patients considered adherent versus non-adherent. Conclusion SPUR is a valid tool to evaluate the risk of non-adherence of patients, allowing effective intervention by providing insights into the respective individual reasons for lack of adherence.

SPUR: A Patient-Reported Medication Adherence Model as a Predictor of Admission and Early Readmission in Patients Living with Type 2 Diabetes

“…The proposed SPUR model framework 31 and initial model development 32 process have been reported previously. Furthermore, psychometric properties for populations based in the US 33 and France 34 have been reported, in addition to a UK-based cohort of patients living with type 2 diabetes (VMATT2) 35 that produced a more concise SPUR tool – SPUR-27. This study sought to develop a predictive model of early readmission and general admission risk using the SPUR-27 tool as a holistic PROM of medication adherence.…”

SPUR-27 – Psychometric Properties of a Patient-Reported Outcome Measure of Medication Adherence in Chronic Obstructive Pulmonary Disease

“…19,20 The four key domains of MA termed Social, Psychographic, Usage, and Rational comprise the 45-item measure and can be used to evaluate individual factors and behaviours related to non-adherence. 21,22 Recently, a shorter 27-item version of the SPUR tool (SPUR-27) was validated for patients living with type 2 diabetes in a UK study by Wells et al 23 The revised 27-item model demonstrated greater reliability than the original SPUR-45 tool as well as significant correlations with objective and PROMs of MA in addition to socio-clinical factors such as body mass index (BMI) and income. The psychometric properties of the tool, as well as its relationship to patient socio-clinical factors, have yet to be evaluated in patients living with COPD.…”