Saudi cultural adaptation of the “compliance questionnaire of Rheumatology” for Rheumatoid arthritis patients on disease modifying anti-rheumatic drugs (DMARDs)

Abstract

Purpose This study aims to develop a valid and reliable Arabic version of the Compliance Questionnaire on Rheumatology (CQR-A) and to explore the impact of demographic factors on compliance. Methods This is a descriptive cross-sectional study carried out at the outpatient clinics of rheumatology in King Fahad hospital (KFH) in Madinah, Saudi Arabia, from May 2019 to October 2019. Initially, the original version was culturally adapted to an Arabic version by forward translation, backward translation, committee review of both the Arabic and the original versions, and lastly, pre-testing. Then, seventy-two rheumatoid arthritis patients were recruited to evaluate the reliability and validity of the CQR-A. Reliability was assessed by the test–retest method with a two-week interval through the intraclass correlation coefficient (ICC). The criterion validity of the CQR-A was assessed through Pearson correlation of pharmacy refill and CQR-A. The content validity index (CVI) was used to determine content validity. Multiple regression analysis was done to evaluate the effect of demographic factors on compliance. Results The CQR-A has adequate reliability and validity. The ICC = 0.757 with a 95% CI ranging from 0.579 to 0.860, p < 0.001, Cronbach’s alpha coefficient = 0.788. Pearson correlation coefficient was found to be (r = 0.338, p = 0.013). The individual content validity index (I-CVI) ranged from 0.67 to 1.00, and the average scale content validity index (S-CVI/Ave) = 0.91. Education was the only significant predictor of compliance amongst the demographic factors with R2 of 0.158. Conclusion The Arabic version of the Compliance Questionnaire on Rheumatology (CQR-A) is a reliable and valid clinical tool to assess compliance in Arabic speaking patients.

Validity and Reliability of the Thai Version of the 19-Item Compliance-Questionnaire-Rheumatology

“…The test-retest reliability yielded an ICC of 0.64 for the total Thai CQR-19 score, which was comparable to the Korean (0.71), Spanish (0.76), Arabic (0.76), and Turkish (0.63) adaptations, respectively). [22][23][24][25] Internal consistency as assessed by Cronbach's alpha (0.83) was also comparable to the Spanish (0.86), Arabic (0.79), and Turkish (0.83) adaptation, respectively. [23][24][25] These reliability results were adequate and acceptable.…”

“…[22][23][24][25] Internal consistency as assessed by Cronbach's alpha (0.83) was also comparable to the Spanish (0.86), Arabic (0.79), and Turkish (0.83) adaptation, respectively. [23][24][25] These reliability results were adequate and acceptable. 50,51 The median completion time of approximately five minutes was shorter than reported in previous studies (English, 12 minutes; Turkish, 10-15 minutes).…”

“…11,44 Previous studies have described a good correlation between CQR-19 and compliance using MEMs, pharmacy refill, and self-reported questionnaire. [22][23][24][25] Initially, we found no agreement between the Thai CQR-19 and the pill count when analysed using Cohen' s kappa. We found a discordance between kappa and the percentage of agreement due to asymmetric data.…”

“…The predictive value to detect poor compliance was 86% and to detect good compliance was 83%. 21 The CQR-19 has been translated into many languages and used in many countries, [22][23][24][25] including Thailand. 26 Therefore, we aimed to evaluate the psychometric properties and satisfaction of the Thai version of the CQR-19 (Thai CQR-19).…”

Exploring Factors Influencing Medication Compliance in Saudi Rheumatoid Arthritis Patients: A Nationwide Cross-Sectional Survey – Results from the COPARA Study

“…The 19 and 5 item Compliance Questionnaire for Rheumatology (CQR) versions were only recently validated in the Arabic language. 10 , 11 The current study aimed to establish compliance on large sample size and study the impact of patient-related factors, disease characteristics, medication frequency, and route administration.…”