Self-report adherence measures in chronic illness: Retest reliability and predictive validity

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

Research output: Contribution to journalArticle

57 Scopus citations

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 1 2008

Keywords

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

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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