TY - JOUR
T1 - Self-report adherence measures in chronic illness
T2 - Retest reliability and predictive validity
AU - Jerant, Anthony
AU - Dimatteo, Robin
AU - Arnsten, Julia
AU - Moore-Hill, Monique
AU - Franks, Peter
PY - 2008/11
Y1 - 2008/11
N2 - 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.
AB - 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.
KW - Chronic disease
KW - Health care surveys
KW - Outcome assessment
KW - Patient compliance
KW - Reproducibility of results
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U2 - 10.1097/MLR.0b013e31817924e4
DO - 10.1097/MLR.0b013e31817924e4
M3 - Article
C2 - 18953223
AN - SCOPUS:55649102617
SN - 0025-7079
VL - 46
SP - 1134
EP - 1139
JO - Medical Care
JF - Medical Care
IS - 11
ER -
