Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care.

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Tytuł:: Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care.
Autorzy:: Fredericksen RJ; University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA. Electronic address: .
Yang FM; Augusta University, 1120 15th Street Augusta, GA, 30912, USA.
Gibbons LE; University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA.
Edwards TC; University of Washington, Quality of Life Group, Box 359455, Seattle, WA, 98195, USA.
Brown S; University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA.
Fitzsimmons E; University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA.
Alperovitz-Bichell K; Chase Brexton Health Care, 5500 Knoll N Dr #370, Columbia, MD, 21045, USA.
Godfrey M; Beaufort Jasper Hampton Comprehensive Health Services, 1520 Grays Highway, Ridgeland, SC, 29936, USA.
Wang A; Chase Brexton Health Care, 5500 Knoll N Dr #370, Columbia, MD, 21045, USA.
Church A; University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA.
Gutierrez C; Fenway Community Health, 1340 Boylston Street, Boston, MA, 02215, USA.
Paez E; University of California-San Diego, The Owen Clinic, 4168 Front Street, San Diego, CA, 92103, USA.
Dant L; Fenway Community Health, 1340 Boylston Street, Boston, MA, 02215, USA.
Loo S; Fenway Community Health, 1340 Boylston Street, Boston, MA, 02215, USA.
Walcott M; University of Alabama-Birmingham, 1917 Clinic, Community Care Building, 908 South 20th Street, Birmingham, AL, 35294, USA.
Mugavero MJ; University of Alabama-Birmingham, 1917 Clinic, Community Care Building, 908 South 20th Street, Birmingham, AL, 35294, USA.
Mayer KH; Fenway Community Health, 1340 Boylston Street, Boston, MA, 02215, USA.
Mathews WC; University of California-San Diego, The Owen Clinic, 4168 Front Street, San Diego, CA, 92103, USA.
Patrick DL; University of Washington, Quality of Life Group, Box 359455, Seattle, WA, 98195, USA.
Crane PK; University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA.
Crane HM; University of Washington, Center for AIDS Research, 325 Ninth Avenue, Box 359931, Seattle, WA, 98104, USA.
Źródło:: Research in social & administrative pharmacy : RSAP [Res Social Adm Pharm] 2019 Sep; Vol. 15 (9), pp. 1168-1176. Date of Electronic Publication: 2018 Oct 05.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Original Publication: New York, NY : Elsevier
MeSH Terms:: Chronic Disease/*drug therapy
HIV Infections/*drug therapy
Medication Adherence/*statistics & numerical data
Adult ; Female ; Humans ; Male ; Middle Aged ; Self Report
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Grant Information:: P30 AI027767 United States AI NIAID NIH HHS; U01 AR057954 United States AR NIAMS NIH HHS; T32 HS022242 United States HS AHRQ HHS; R24 AI067039 United States AI NIAID NIH HHS; P30 AI027757 United States AI NIAID NIH HHS; U01 AA020793 United States AA NIAAA NIH HHS
Contributed Indexing:: Keywords: Medication adherence; Patient-reported outcomes
Entry Date(s):: Date Created: 20181018 Date Completed: 20200511 Latest Revision: 20210312
Update Code:: 20240105
PubMed Central ID:: PMC7946330
DOI:: 10.1016/j.sapharm.2018.10.001
PMID:: 30327183
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Background: Providers are often unaware of poor adherence to prescribed medications for their patients with chronic diseases.
Objective: To develop brief, computer-administered patient-reported measures in English and Spanish assessing adherence behaviors and barriers. Design, Participants, and Main Measures: Item pools were constructed from existing measures of medication adherence behaviors and barriers, which informed development of a patient concept elicitation interview guide to identify medication adherence behavior and barrier-related concepts. Two hundred six patients either living with HIV (PLWH) or without were interviewed. Interviews were coded, concepts matched to item pool content, and new items were developed for novel concepts. A provider/investigator team highlighted clinically relevant items. Cognitive interviews were conducted with patients on final candidate items (n = 37). The instruments were administered to 2081 PLWH.
Key Results: Behavioral themes from concept elicitation interviews included routines incorporating time of day, placement, visual cues, and intentionality to miss or skip doses. Barrier themes included health-related (e.g. depressed mood, feeling ill), attitudes/beliefs (e.g., need for medication), access (e.g., cost/insurance problems), and circumstantial barriers (e.g., lack of privacy, disruption of daily routine). The final instruments included 6 behavior items, and 1 barrier item with up to 23 response options. PLWH endorsed a mean (SD) of 3.5 (1.1) behaviors. The 201 PLWH who missed ≥2 doses in the previous week endorsed a mean (SD) of 3.1 (2.5) barriers. The intraclass correlation coefficient (ICC) for the numbers of behaviors endorsed in 61 PLWH after 4-16 days was 0.54 and for the number of barriers for the 20 PLWH with ≥2 missed doses the ICC was 0.89, representing fair and excellent test-retest reliability.
Conclusion: Measures of medication adherence behaviors and barriers were developed for use with patients living with chronic diseases focusing on clinical relevance, brevity, and content validity for use in clinical care.
(Copyright © 2018. Published by Elsevier Inc.)

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