Self-report adherence measures in chronic illness

Retest reliability and predictive validity

Anthony Jerant, Robin Dimatteo, Julia H. Arnsten, Monique Moore-Hill, Peter Franks

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background: Patient self-report is a practical method for measuring adherence, but little is known about its optimal use. Objectives: To examine the retest reliability and predictive validity of 3 different types of self-report adherence measures among patients with common chronic illnesses. Research Design: Correlation and regression analyses of data from an ongoing randomized controlled trial. Subjects: Patients (N ≤ 415) aged ĝ‰¥40 years recruited from a primary care network with arthritis, asthma, chronic lung disease, congestive heart failure, depression, and/or diabetes mellitus, plus impairment in ĝ‰¥1 basic activity and/or a score of ĝ‰¥4 on the 10-item Center for Epidemiologic Studies Depression Scale. Measures: Self-report adherence (administered variously at baseline, 2, 4, and 6 weeks, and 6 months): number of pills taken/number of pills prescribed (PT/PP), using 1ĝ€"7 days recall, and global reports of medication adherence and overall adherence tendencies. Six-month functional outcomes: Health Assessment Questionnaire (HAQ) and Short Form-36 (SF-36). Results: Correlation coefficients among contemporaneously administered 1ĝ€"7 days PT/PP measures were ĝ‰¥0.78. Correlations among PT/PP measures and global adherence measures, and among PT/PP measures at 2 and 4 weeks, ranged from 0.11 to 0.54. PT/PP measures using ĝ‰¥3ĝ€"4 days recall significantly predicted adjusted 6-month HAQ but not SF-36 score. Conclusions: Self-report PT/PP and general medication adherence measures tap different behavioral constructs. Self-reported PT/PP at a given point in time is not necessarily representative of medication adherence over time. Among chronically ill patients, 3ĝ€"4 days recall of PT/PP yield adherence estimates, which are practically as reliable and valid as longer intervals and which predict functional outcomes.

Original languageEnglish (US)
Pages (from-to)1134-1139
Number of pages6
JournalMedical Care
Volume46
Issue number11
DOIs
StatePublished - Nov 2008

Fingerprint

Reproducibility of Results
Self Report
Medication Adherence
Chronic Disease
Depression
Health
Lung Diseases
Arthritis
Epidemiologic Studies
Primary Health Care
Diabetes Mellitus
Research Design
Asthma
Randomized Controlled Trials
Heart Failure
Regression Analysis
Outcome Assessment (Health Care)
Surveys and Questionnaires

Keywords

  • Chronic disease
  • Health care surveys
  • Outcome assessment
  • Patient compliance
  • Reproducibility of results

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Self-report adherence measures in chronic illness : Retest reliability and predictive validity. / Jerant, Anthony; Dimatteo, Robin; Arnsten, Julia H.; Moore-Hill, Monique; Franks, Peter.

In: Medical Care, Vol. 46, No. 11, 11.2008, p. 1134-1139.

Research output: Contribution to journalArticle

Jerant, Anthony ; Dimatteo, Robin ; Arnsten, Julia H. ; Moore-Hill, Monique ; Franks, Peter. / Self-report adherence measures in chronic illness : Retest reliability and predictive validity. In: Medical Care. 2008 ; Vol. 46, No. 11. pp. 1134-1139.
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