Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care
Providers are often unaware of poor adherence to prescribed medications for their patients with chronic diseases. To develop brief, computer-administered patient-reported measures in English and Spanish assessing adherence behaviors and barriers. Design, Participants, and Main Measures: Item pools w...
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| Veröffentlicht in: | Research in social and administrative pharmacy 2019-09, Vol.15 (9), p.1168-1176 |
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| creator | Fredericksen, R.J. Yang, F.M. Gibbons, L.E. Edwards, T.C. Brown, S. Fitzsimmons, E. Alperovitz-Bichell, K. Godfrey, M. Wang, A. Church, A. Gutierrez, C. Paez, E. Dant, L. Loo, S. Walcott, M. Mugavero, M.J. Mayer, K.H. Mathews, W.C. Patrick, D.L. Crane, P.K. Crane, H.M. |
| description | Providers are often unaware of poor adherence to prescribed medications for their patients with chronic diseases.
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.
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.
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. |
| doi_str_mv | 10.1016/j.sapharm.2018.10.001 |
| format | Article |
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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.
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.
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.</description><identifier>ISSN: 1551-7411</identifier><identifier>EISSN: 1934-8150</identifier><identifier>DOI: 10.1016/j.sapharm.2018.10.001</identifier><identifier>PMID: 30327183</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Chronic Disease - drug therapy ; Female ; HIV Infections - drug therapy ; Humans ; Male ; Medication adherence ; Medication Adherence - statistics & numerical data ; Middle Aged ; Patient-reported outcomes ; Self Report</subject><ispartof>Research in social and administrative pharmacy, 2019-09, Vol.15 (9), p.1168-1176</ispartof><rights>2018</rights><rights>Copyright © 2018. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-a67c98bf780405155e22ca95b4d40a62df86b51c56775f74f9cca841a682ee3</citedby><cites>FETCH-LOGICAL-c467t-a67c98bf780405155e22ca95b4d40a62df86b51c56775f74f9cca841a682ee3</cites><orcidid>0000-0001-5054-2543 ; 0000-0003-0075-5879 ; 0000-0001-9990-9318 ; 0000-0001-7460-733X ; 0000-0002-2352-0725 ; 0000-0002-2473-5824</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1551741118302754$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30327183$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fredericksen, R.J.</creatorcontrib><creatorcontrib>Yang, F.M.</creatorcontrib><creatorcontrib>Gibbons, L.E.</creatorcontrib><creatorcontrib>Edwards, T.C.</creatorcontrib><creatorcontrib>Brown, S.</creatorcontrib><creatorcontrib>Fitzsimmons, E.</creatorcontrib><creatorcontrib>Alperovitz-Bichell, K.</creatorcontrib><creatorcontrib>Godfrey, M.</creatorcontrib><creatorcontrib>Wang, A.</creatorcontrib><creatorcontrib>Church, A.</creatorcontrib><creatorcontrib>Gutierrez, C.</creatorcontrib><creatorcontrib>Paez, E.</creatorcontrib><creatorcontrib>Dant, L.</creatorcontrib><creatorcontrib>Loo, S.</creatorcontrib><creatorcontrib>Walcott, M.</creatorcontrib><creatorcontrib>Mugavero, M.J.</creatorcontrib><creatorcontrib>Mayer, K.H.</creatorcontrib><creatorcontrib>Mathews, W.C.</creatorcontrib><creatorcontrib>Patrick, D.L.</creatorcontrib><creatorcontrib>Crane, P.K.</creatorcontrib><creatorcontrib>Crane, H.M.</creatorcontrib><title>Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care</title><title>Research in social and administrative pharmacy</title><addtitle>Res Social Adm Pharm</addtitle><description>Providers are often unaware of poor adherence to prescribed medications for their patients with chronic diseases.
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.
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.
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.</description><subject>Adult</subject><subject>Chronic Disease - drug therapy</subject><subject>Female</subject><subject>HIV Infections - drug therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Medication adherence</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Middle Aged</subject><subject>Patient-reported outcomes</subject><subject>Self Report</subject><issn>1551-7411</issn><issn>1934-8150</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUcuO1DAQtBCIXQY-AeQjlwx2YsfJBYSWp7QSB7hbHaez41FiD-4k0v49DjOs4MSpH67qdlcx9lKKvRSyfnPcE5wOkKZ9KWSTe3sh5CN2LdtKFY3U4nHOtZaFUVJesWdERyEqI6R6yq4qUZVGNtU1Sx9wxTGeJgwzh9BzF8O85SuMvofZx8DjwCcEWhISByIk8uGOQ3_AhMEh7yAlj4l-8zs8wOpjroaY-ELIfeBu9ME7GLmDhM_ZkwFGwheXuGPfP338cfOluP32-evN-9vCqdrMBdTGtU03mEYoofMpWJYOWt2pXgmoy35o6k5Lp2tj9GDU0DoHjZJQNyVitWNvz1NPSzdh7_JNCUZ7Sn6CdG8jePvvS_AHexdXa1pVV1mgHXt9GZDizwVptpMnh-MIAeNCtpSlVG0WscpQfYa6FIkSDg9rpLCbW_ZoL27Zza2tnd3KvFd___GB9ceeDHh3BmDWac0aW3J-07z3Cd1s--j_s-IXMm2sCA</recordid><startdate>20190901</startdate><enddate>20190901</enddate><creator>Fredericksen, R.J.</creator><creator>Yang, F.M.</creator><creator>Gibbons, L.E.</creator><creator>Edwards, T.C.</creator><creator>Brown, S.</creator><creator>Fitzsimmons, E.</creator><creator>Alperovitz-Bichell, K.</creator><creator>Godfrey, M.</creator><creator>Wang, A.</creator><creator>Church, A.</creator><creator>Gutierrez, C.</creator><creator>Paez, E.</creator><creator>Dant, L.</creator><creator>Loo, S.</creator><creator>Walcott, M.</creator><creator>Mugavero, M.J.</creator><creator>Mayer, K.H.</creator><creator>Mathews, W.C.</creator><creator>Patrick, D.L.</creator><creator>Crane, P.K.</creator><creator>Crane, H.M.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5054-2543</orcidid><orcidid>https://orcid.org/0000-0003-0075-5879</orcidid><orcidid>https://orcid.org/0000-0001-9990-9318</orcidid><orcidid>https://orcid.org/0000-0001-7460-733X</orcidid><orcidid>https://orcid.org/0000-0002-2352-0725</orcidid><orcidid>https://orcid.org/0000-0002-2473-5824</orcidid></search><sort><creationdate>20190901</creationdate><title>Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care</title><author>Fredericksen, R.J. ; Yang, F.M. ; Gibbons, L.E. ; Edwards, T.C. ; Brown, S. ; Fitzsimmons, E. ; Alperovitz-Bichell, K. ; Godfrey, M. ; Wang, A. ; Church, A. ; Gutierrez, C. ; Paez, E. ; Dant, L. ; Loo, S. ; Walcott, M. ; Mugavero, M.J. ; Mayer, K.H. ; Mathews, W.C. ; Patrick, D.L. ; Crane, P.K. ; Crane, H.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-a67c98bf780405155e22ca95b4d40a62df86b51c56775f74f9cca841a682ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Chronic Disease - drug therapy</topic><topic>Female</topic><topic>HIV Infections - drug therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Medication adherence</topic><topic>Medication Adherence - statistics & numerical data</topic><topic>Middle Aged</topic><topic>Patient-reported outcomes</topic><topic>Self Report</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fredericksen, R.J.</creatorcontrib><creatorcontrib>Yang, F.M.</creatorcontrib><creatorcontrib>Gibbons, L.E.</creatorcontrib><creatorcontrib>Edwards, T.C.</creatorcontrib><creatorcontrib>Brown, S.</creatorcontrib><creatorcontrib>Fitzsimmons, E.</creatorcontrib><creatorcontrib>Alperovitz-Bichell, K.</creatorcontrib><creatorcontrib>Godfrey, M.</creatorcontrib><creatorcontrib>Wang, A.</creatorcontrib><creatorcontrib>Church, A.</creatorcontrib><creatorcontrib>Gutierrez, C.</creatorcontrib><creatorcontrib>Paez, E.</creatorcontrib><creatorcontrib>Dant, L.</creatorcontrib><creatorcontrib>Loo, S.</creatorcontrib><creatorcontrib>Walcott, M.</creatorcontrib><creatorcontrib>Mugavero, M.J.</creatorcontrib><creatorcontrib>Mayer, K.H.</creatorcontrib><creatorcontrib>Mathews, W.C.</creatorcontrib><creatorcontrib>Patrick, D.L.</creatorcontrib><creatorcontrib>Crane, P.K.</creatorcontrib><creatorcontrib>Crane, H.M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Research in social and administrative pharmacy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fredericksen, R.J.</au><au>Yang, F.M.</au><au>Gibbons, L.E.</au><au>Edwards, T.C.</au><au>Brown, S.</au><au>Fitzsimmons, E.</au><au>Alperovitz-Bichell, K.</au><au>Godfrey, M.</au><au>Wang, A.</au><au>Church, A.</au><au>Gutierrez, C.</au><au>Paez, E.</au><au>Dant, L.</au><au>Loo, S.</au><au>Walcott, M.</au><au>Mugavero, M.J.</au><au>Mayer, K.H.</au><au>Mathews, W.C.</au><au>Patrick, D.L.</au><au>Crane, P.K.</au><au>Crane, H.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care</atitle><jtitle>Research in social and administrative pharmacy</jtitle><addtitle>Res Social Adm Pharm</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>15</volume><issue>9</issue><spage>1168</spage><epage>1176</epage><pages>1168-1176</pages><issn>1551-7411</issn><eissn>1934-8150</eissn><abstract>Providers are often unaware of poor adherence to prescribed medications for their patients with chronic diseases.
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.
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.
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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30327183</pmid><doi>10.1016/j.sapharm.2018.10.001</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5054-2543</orcidid><orcidid>https://orcid.org/0000-0003-0075-5879</orcidid><orcidid>https://orcid.org/0000-0001-9990-9318</orcidid><orcidid>https://orcid.org/0000-0001-7460-733X</orcidid><orcidid>https://orcid.org/0000-0002-2352-0725</orcidid><orcidid>https://orcid.org/0000-0002-2473-5824</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Research in social and administrative pharmacy, 2019-09, Vol.15 (9), p.1168-1176 |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Chronic Disease - drug therapy Female HIV Infections - drug therapy Humans Male Medication adherence Medication Adherence - statistics & numerical data Middle Aged Patient-reported outcomes Self Report |
| title | Development and content validation of measures assessing adherence barriers and behaviors for use in clinical care |
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