Self-reported Measure Of Medication Adherence Research Articles

Development and Preliminary Psychometric Testing of a Brief Tool to Measure Medication Adherence in Older Populations.

Chronic diseases in older age are major sources of burden for healthcare systems. Compliance with medications is the key to treatment success for these patients, especially for frail individuals living in community settings. However, adherence to long-term medications in this population is not optimal, which leads to the need for frequent screening of compliance within large-scale public health surveys. In this context, a brief, simple and valid measure capturing medication adherence is not yet available. This study aims to develop and psychometrically test the Therapeutic Adherence Scale, a brief four-item tool that measures medication adherence in community-dwelling older adults affected by chronic diseases. We conducted a three-phase process of instrument development, content validity assessment and psychometric testing. Of the candidate nine items derived from a review of the literature, only four were deemed essential to capture intentional and nonintentional nonadherence. These items underwent structural validity, convergent and known-groups validity, and internal consistency on a sample of 269 participants (mean age = 7.91 years, SD = 7.26). Confirmatory factor analysis confirmed satisfactory fit indices (RMSEA = 0.000, CFI = 1.00, TLI = 1.00). Scores of the TAS were higher for those perceiving loneliness (ρ = 0.33, p < 0.001), those declaring memory loss in the last year (ρ = 0.29, p < 0.001), and those exhibiting worse mental quality of life (ρ = -0.15, p = 0.03) compared with the other groups. Cronbach's alpha and split-half reliability coefficients were acceptable, with values of 0.68 and 0.77, respectively. The Therapeutic Adherence Scale is a brief, valid and reliable self-report measure of medication adherence that can be used in practice and research to screen patients living in community settings. This tool is also free to use, which contributes to advancing knowledge on the field of medication adherence of older adults affected by chronic diseases.

Investigation of Medication Adherence and Factors Affecting It in Patients With Stroke.

BACKGROUND: Medication adherence is important in reducing the rate of secondary stroke in patients previously given a diagnosis of stroke. Therefore, there is a need to examine medication adherence and the factors affecting it in these patients. This study aimed to examine medication adherence in patients with stroke and the factors affecting it. METHODS: This study adopted a descriptive and cross-sectional design carried carried out on 183 stroke patients. Data were obtained between January and December 2019 using a sociodemographic and clinical characteristics form, the Morisky's Questions - Self-Reported Measure of Medication Adherence, the Turkish translation of the Beliefs about Medicines Questionnaire, the Nottingham Extended Activities of Daily Living Scale, and the revised Turkish version of Mini-Mental State Examination. RESULTS: The proportion of patients with high medication adherence was 33.9%. The sociodemographic and clinical characteristics of patients with stroke were found as not effective factors in medication adherence. Specific concerns and general overuse in the Turkish translation of the Beliefs about Medicines Questionnaire were found as factors affecting medication adherence. The Nottingham Extended Activities of Daily Living Scale and its subscales were found to be not effective factors in medication adherence. CONCLUSION: According to the results, the proportion of patients with high medication adherence was low. Patients' concerns about the possible side effects of their prescribed medications and beliefs about the overuse of medications negatively affected their medication adherence. It is recommended that nurses evaluate patients' medication adherence and beliefs about medications during hospitalization, discharge, or home visits. Structured nurse-led intervention programs are needed to enhance patients' medication adherence and beliefs about their medications.

Strategies to Improve Adherence to Anti-Hypertensive Medications: a Narrative Review.

Medication adherence is critical for effective management of hypertension, yet half of patients with hypertension are non-adherent to medications. In this review, we describe and critically evaluate medication adherence interventions published in the past 3years for patients with hypertension. We identified 1593 articles and 163 underwent full review, of which 42 studies met the inclusion criteria. Studies were classified into eight categories: simplification of medication regimen (e.g., fixed dose combination pills); electronic Health (eHealth) tools (e.g., text messaging reminders); behavioral counseling (e.g., motivational interviewing); healthcare system changes (e.g., patient-centered medical home); patient education; multicomponent chronic disease management program; home blood pressure monitoring; and financial incentives. Studies utilizing strategies to simplify medication regimens, eHealth tools, patient education, and behavioral counseling were most likely to report positive findings. Interventions targeting patient behavior were more likely to be associated with improvements in medication adherence compared to those targeting providers or the healthcare system. eHealth tools show promise for augmenting behavioral interventions. A major limitation of included trials was short study duration and use of self-report measures of medication adherence. Future research should explore how complex interventions that utilize a combination of evidence-based strategies and target multiple adherence behaviors (e.g., both day-to-day medication taking and long-term persistence) may be efficacious in improving medication adherence.

Randomized Trial of a Smartphone Mobile App to Improve Symptoms and Adherence to Oral Therapy for Cancer.

Patients with cancer are increasingly prescribed oral therapies, bearing greater responsibility for self-management of treatment adherence and adverse events. We conducted a randomized trial to test the use of a smartphone mobile app to improve symptoms and adherence to oral cancer therapy. From February 18, 2015, through December 31, 2016, 181 patients with diverse cancers who were prescribed oral therapy were randomized to receive either the smartphone mobile app or standard care. The mobile app included a medication plan with reminders, a symptom-reporting module, and patient education. Primary outcomes were adherence (per electronic pill caps), symptom burden (per MD Anderson Symptom Inventory), and quality of life (per the Functional Assessment of Cancer Therapy-General). Participants also completed self-report measures of medication adherence, anxiety and depression symptoms, social support, quality of care, and healthcare utilization. Linear regression was used to assess intervention effects on adherence and change in self-report outcomes from baseline to week 12, controlling for baseline scores and social support. Study groups did not differ across any outcome measure, with an overall mean adherence of 78.81% (SD, 26.66%) per electronic pill caps. However, moderation analyses showed that intervention effects on the primary adherence measure varied by baseline self-reported adherence and anxiety symptoms. Specifically, adherence rates per electronic pill caps were higher in patients randomized to the mobile app versus standard care within the subsamples of patients who reported baseline adherence problems (mean difference, -22.30%; 95% CI, -42.82 to -1.78; P=.034) and elevated anxiety (mean difference, -16.08%; 95% CI, -31.74 to -0.41; P=.044). Although the mobile app may not improve outcomes for all patients prescribed oral cancer therapy, the intervention may be beneficial for those with certain risk factors, such as difficulties with adherence or anxiety.

4036The knowledge as the determinant of the adherence to antihypertensive treatment

Abstract Introduction The education of the patients with cardio-vascular diseases aims to modify the present risk factors and to increase the aware participation in the therapy. Arterial hypertension is one of the most common modifiable risk factors of cardio-vascular diseases. However, the knowledge of the self-care and adherence to therapeutic recommendations are highly disappointing. Understanding people's levels of knowledge on cardiovascular risk factors and its relation to level of adherence in antihypertensive treatment might contribute effectively to medical staff efforts to prevent, treat and control the disease. The aim of the study was analysis of the knowledge of the cardio-vascular risk factors and the adherence to therapeutic recommendations. Material and methods 101 patients (mean age 57.5±13.2) with arterial hypertension (stage I and II according to ESC) were enrolled into the study. The following questionnaires were used: Morisky's Self-Reported Measure of Medication Adherence (MMAS-8-Item), Hill-Bone Compliance to High Blood Pressure Therapy Scale (Hill-Bone Scale) and The Cardiovascular Disease Risk Factors Knowledge Level Scale (CARRF). Results 41% of the patients had worse knowledge of the cardio-vascular risk factors. In comparative analysis there were the significant differences in adherence to treatment with regards to the knowledge according to CRRRF questionnaire. The patients with better knowledge had the best adherence, which diminished along with worsening the knowledge (19.0±3.5 vs 18.3±3.7 vs 16.6±4.1). The increase of the knowledge by one point in scale CARRF-KL was accompanied by the increase of the adherence by 0.14 point (mean). The relations between knowledge and adherence was observed in terms of the treatment (8.3±2.0 vs 10.1±5.0 vs 8.9±3.5; p=0.003) and the global results of Hill-Bone questionnaire (19.5±4.4 vs 22.7±7.3). The relation between the knowledge and the adherence in terms of salt intake or control check-ups was not proved. In multiple regression analysis the knowledge was significant independent determinant, which influenced the adherence in terms of the treatment MMAS (b= 0.253; p=0.0004) Conclusions Adherence to therapeutic recommendations is related to the knowledge of the cardio-vascular risk factors, i.e. the better knowledge, the better adherence. The knowledge is the independent predictor of adherence to treatment in patients with arterial hypertension. The identification of knowledge deficits as a factor contributing to lack of adherence and poor hypertension control remains a key challenge for clinicians caring for patients with hypertension.

Psychometric evaluation of medication adherence rating scale (MARS) among Nigerian patients with schizophrenia.

The Medication Adherence Rating Scale (MARS) is a 10-item self-report measure of medication adherence in psychosis which is a vital predictor of illness course and outcome in patient with schizophrenia. The initial and subsequent studies have shown that MARS has good reliability and validity scores after correction for the small sample size in the index study. This study aimed to determine the psychometric properties of MARS among outpatients with schizophrenia at the outpatient clinic of the Neuropsychiatric Hospital Aro Abeokuta Ogun State Nigeria. Intra-class correlation coefficient (ICC) was used to determine the internal consistency, item-total correlations, and reliability of the instrument. Factor analysis was done using principal component analysis with varimax rotation. The intra-class correlation coefficient (ICC) for these 10 items (at time T1) was 0.6 with a P value of <0.001 while for the test--retest analysis was 0.7 with a P value of 0.04. A principal components factor analysis with varimax rotation produced a four-factor solution and factor 4 was found to be the most internally consistent, with Cronbach's alpha of 0.63. This study supports the internal consistency, test--retest reliability, and constructs validity of the MARS.

The effect of motivational interviews on treatment adherence and insight levels of patients with schizophrenia: A randomized controlled study

To examine the effect of motivational interview (MI) on treatment adherence and insight of the patients diagnosed with schizophrenia at a hospital in Turkey. Individuals with schizophrenia, who match with the sample characteristics, were assigned to intervention (20) and control groups (20) according to the randomization schedule. Personal Information Form, Self-Reported Measure of Medication Adherence, and Schedule for Assessing the Three Components of Insight were used. Group-wise examinations showed that mean scores of "three component scales of insight" yielded statistically significant difference for the intervention group. Analysis of the Treatment Adherence Scale Mean Scores showed a significant difference for interval mean scores of the intervention group. Both the pyschiatric patients and the health institutions can benefit from increased levels of treatment adherence and insight by the adoption of the MI methods starting with a patient's first registration to a psychiatric outpatient clinic. MI can be included during any of the patient visits to establish treatment collaboration with psychiatric patients at psychiatric facilities, outpatient clinics, and community mental health centers.

Association of Social Support and Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus.

The prevalence of diabetes is steadily increasing in China. When diabetes is uncontrolled, it generates dire consequences for health and well-being. Numerous studies have shown that health outcomes were associated with social support and medication adherence. Previous study confirmed that social support was associated with medication adherence in patients with heart failure, HIV diseases, and first-episode psychosis. However, the relationship between social support and medication adherence in patients with type 2 diabetes mellitus (T2DM) is remains unclear. This study aims to examine whether social support is associated with medication adherence in patients with T2DM. This study was conducted in the First Affiliated Hospital of the General Hospital of the People’s Liberation Army (PLA). In Beijing, a systematic random sample of 412 patients with T2DM over 18 years was recruited at baseline, and demographic characteristics, clinical data and their assessment of social support were collected from medical records and self-reported questionnaires. 330 of these patients completed a self-report measure of medication adherence at the sixth month after baseline data collection. Regression analysis showed that social support presented a positive effect on medication adherence, additionally, support utilization and the subscale of social support exhibited a significantly strong influence on medication adherence in patients with T2DM. Although medication adherence was influenced by multiple factors, this finding confirmed that social support must be recognized as a core element in interventions aimed at improving in the management of patients with T2DM.

Pilot study of a culturally adapted psychoeducation (CaPE) intervention for bipolar disorder in Pakistan

BackgroundDespite the use of maintenance medication, recurrence rates in bipolar affective disorder (BPAD) are high. To date, there are no clinical trials that have investigated the use of psychological interventions in bipolar disorder in Pakistan.AimThe purpose of the study was to assess the feasibility and acceptability of a culturally adapted bipolar psychoeducation programme (CaPE) in Pakistan.MethodsThirty-four euthymic bipolar I and II outpatients were randomized to either 12 weekly sessions of individual psychoeducation plus Treatment As Usual (Intervention) or Treatment As Usual (TAU) (Control). Outcomes were assessed using the Young Mania Rating Scale (YMRS), Beck Depression Inventory (BDI), EuroQoL (EQ-5D), Bipolar Knowledge and Attitudes and Questionnaire (BKAQ), and a self-reported measure of medication adherence (Morisky Medication Adherence Scale-4 items, MMAS-4). Effect sizes were derived from baseline adjusted standardized regression coefficients.ResultsRetention in the study was good, 80% of patients in the TAU follow-up assessment and 100% of patients in the CaPE group attended all 12 sessions. Patient satisfaction was higher in the CaPE group relative to control (ES = 1.41). Further, there were large effect sizes shown for CaPE versus TAU for medication adherence (MMAS-4: ES = 0.81), knowledge and attitudes towards bipolar (BKAQ: ES = 0.68), mania (YMRS: ES = 1.18), depression (BDI: ES = 1.17) and quality of life measures (EQ-5D: ES ⇒ 0.88).ConclusionsCulturally adapted psychoeducation intervention is acceptable and feasible, and can be effective in improving mood symptoms and knowledge and attitudes to BPAD when compared with TAU. Larger scale studies are needed to confirm our findings.Trial registration. Clinicaltrials.gov identifier NCT02210390

Medication Adherence Mediates the Association between Type D Personality and High HbA1c Level in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study.

Aims. To examine the association between Type D personality and HbA1c level and to explore the mediating role of medication adherence between them in patients with type 2 diabetes mellitus (T2DM). Methods. 330 patients went on to complete a self-report measure of medication adherence and the HbA1c tests. Chi-square test, T test, Ordinary Least Square Regression (OLS), and Recentered Influence Function Regression (RIF) were employed. Results. Patients with Type D personality had significantly higher HbA1c value (P < 0.01). When Type D personality was operationalized as a categorical variable, SI was associated with HbA1c (P < 0.01). When NA, SI, and their interaction term were entered into regression, all of them were no longer associated with HbA1c level (P > 0.1). On the other hand, when Type D personality was operationalized as a continuous variable, only SI trait was associated with HbA1c level (P < 0.01). When NA, SI, and NA × SI term together were entered into regression, only SI was not related to HbA1c level. Furthermore, medication adherence had a significant mediation effect between Type D personality and HbA1c, accounting for 54.43% of the total effect. Conclusion. Type D personality was associated with HbA1c in direct and indirect ways, and medication adherence acted as a mediator role.

A Randomised Controlled Trial to Test the Effectiveness of Planning Strategies to Improve Medication Adherence in Patients with Cardiovascular Disease.

Low levels of adherence to medication prescribed to treat and manage chronic disease may lead to maladaptive health outcomes. Theory-based, easy-to-administer interventions that promote patients' effective self-regulation of their medication-taking behaviour are needed if adherence is to be maximised. We tested the effectiveness of an intervention adopting planning techniques to promote medication adherence. Outpatients with cardiovascular disease (N=71) were allocated to either an experimental condition, in which participants were asked to form implementation intentions and coping plans related to their treatment, or to a no-planning control condition, in which participants received no treatment. Patients also completed self-report measures of medication adherence, self-efficacy, and beliefs in medication necessity and concerns. Measures were administered at baseline and at 6-week follow-up. Results revealed nooverall main effect for the intervention on medication adherence. Post-hoc moderator analyses revealed that the intervention was effective in patients withlower necessity beliefs compared to those with higher necessity beliefs. While current findings have promise in demonstrating the conditional effects of planning interventions, there is a need to replicate these findings by manipulating planning and beliefs independently and testing their direct and interactive effects on medication adherence.

Adherencia al tratamiento tras trasplante renal como indicador de calidad de la información recibida: estudio longitudinal con un seguimiento de 2 años

IntroductionTransplantation is an optimal form of treatment for end-stage renal disease, but requires lifelong adherence to immunosuppressive therapy. The aim of this study was to longitudinally assess the adherence to treatment after kidney transplant, as well as to compare the amount of information about the treatment received at one month and 18 months post-transplantation, and its influence on adherence to treatment. Material and methodsThe Self-Reported Measure of Medication Adherence was administered at month (T1), 6 months (T2), 12 months (T3), 18 months (T4), and 24 months (T5) post-transplantation. Survey about aspects of knowledge and attitudes about medication, was administered at one month and 18 months post-transplant. Measures of central tendency and non-parametric tests were used to compare the data. ResultsThe study included a total of 73 patients with a median age of 57 years. The percentage of patients non-adherent to medication was 9.6% (T1), 22.5% (T2), 29.2% (T3), 29.8% (T4), and 28.1% (T5). One month after transplantation “not consulting with the doctor on forgetting to take medication (P=.034) significantly influenced the non-adherence to treatment. At 18 months post- transplantation, none of the issues raised on medication knowledge had an influence on non-adherence to treatment. ConclusionsLonger times since transplantation increased the non-adherence to treatment. Some issues regarding the information of treatment influenced the non-adherence in the immediate transplant period, but not in the follow-up.

Type D Personality Predicts Poor Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study.

BackgroundType D personality and medication nonadherence have been shown to be associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. However, the relationship between type D personality and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM) remains unknown. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM.Design and SettingsA follow-up study was conducted in general hospital of the People's Liberation Army in Beijing.Methods412 T2DM patients (205 females), who were recruited by circular systematic random sampling, provided demographic and baseline data about medical information and completed measures of Type D personality. Then, 330 patients went on to complete a self-report measure of medication adherence at the sixth month after baseline data collection. Chi-square test, t tests, and hierarchical multiple regression analyses were conducted, as needed.ResultsPatients with type D personality were significantly more likely to have poor medication adherence (p<0.001). Type D personality predicts poor medication adherence before and after controlling for covariates when it was analyzed as a categorical variable. However, the dimensional construct of type D personality was not associated with medication adherence when analyzed as a continuous variable.ConclusionAlthough, as a dimensional construct, type D personality may not reflect the components of the personality associated with poor medication adherence in patients with T2DM, screening for type D personality may help to identify those who are at higher risk of poor medication adherence. Interventions, aiming to improve medication adherence, should be launched for these high-risk patients.

Association between self-report adherence measures and oestrogen suppression among breast cancer survivors on aromatase inhibitors

PurposePoor adherence to oral adjuvant hormonal therapy for breast cancer is a common problem, but little is known about the relationship between self-report adherence measures and hormonal suppression. We evaluated the relationship of three self-report measures of medication adherence and oestrogen among patients on aromatase inhibitors (AIs). Materials and methodsWe recruited 235 women with breast cancer who were prescribed AI therapy. Participants self-reported AI adherence by completing the following: (1) a single item asking whether they took an AI in the last month, (2) a modified Morisky Medication Adherence Scale-8 (MMAS-8) and (3) the Visual Analog Scale (VAS). Serum estrone and estradiol were analysed using organic solvent extraction and Celite column partition chromatography, followed by radioimmunoassay. ResultsTen percent of participants reported they had not taken an AI in the last month and among this group, median estrone (33.2pg/ml [interquartile range (IQR)=22.3]) and estradiol levels (7.2pg/mL [IQR=3.3]) were significantly higher than those in participants who reported AI use (median estrone=11.5pg/mL [IQR=4.9]; median estradiol=3.4pg/mL [IQR=2.1]; p<0.001). This relationship held when controlling for race and AI drug type. ConclusionsA single-item monthly-recall adherence measure for AIs was associated with oestrogen serum levels. This suggests that patient-reported monthly adherence may be a useful measure to identify early non-adherence behaviour and guide interventions to improve patient adherence to hormonal treatment.

Psychometric Properties of a Short Self-Reported Measure of Medication Adherence Among Patients With Hypertension Treated in a Busy Clinical Setting in Korea

BackgroundWe examined the psychometric properties of the Korean version of the 8-item Morisky Medication Adherence Scale (MMAS-8) among adults with hypertension.MethodsA total of 373 adults with hypertension were given face-to-face interviews in 2 cardiology clinics at 2 large teaching hospitals in Seoul, South Korea. Blood pressure was measured twice, and medical records were reviewed. About one-third of the participants (n = 109) were randomly selected for a 2-week test-retest evaluation of reliability via telephone interview.ResultsInternal consistency reliability was moderate (Cronbach α = 0.56), and test-retest reliability was excellent (intraclass correlation = 0.91; P < 0.001), although a ceiling effect was detected. The correlation of MMAS-8 scores with scores for the original 4-item scale indicated that convergent validity was good (r = 0.92; P < 0.01). A low MMAS-8 score was significantly associated with poor blood pressure control (χ2 = 29.86; P < 0.001; adjusted odds ratio = 5.08; 95% CI, 2.56–10.08). Using a cut-off point of 6, sensitivity and specificity were 64.3% and 72.9%, respectively. Exploratory factor analysis identified 3 dimensions of the scale, with poor fit for the 1-dimensional construct using confirmatory factory analysis.ConclusionsThe MMAS-8 had satisfactory reliability and validity and thus might be suitable for assessment and counseling regarding medication adherence among adults with hypertension in a busy clinical setting in Korea.

Reliability and validity of a self-reported measure of medication adherence in patients with type 2 diabetes mellitus in Korea

This study examined the psychometric properties of the Korean version of the eight-item Morisky Medication Adherence Scale (MMAS-8) to measure adherence to diabetes medication in patients with type 2 diabetes mellitus. The English version of the MMAS-8 was translated into Korean and administered to patient with type 2 diabetes mellitus via face-to-face interviews, conducted by an independent interviewer. Patient characteristics and glycosylated haemoglobin (HbA1c) levels were assessed at the same clinic visit. A proportion of patients was randomly selected for 2-week test-retest reliability via telephone interviews. Convergent validity of the MMAS-8 against a four-item MMAS, correlations with HbA1c levels and construct validity of the MMAS-8 were evaluated. In total, 317 patients were included; 70 completed the 2-week test-retest interview. Internal consistency reliability was moderate and test-retest reliability of the MMAS-8 was excellent, although a ceiling effect was detected. Good convergent validity was shown by the high correlation of the new scale scores with the original MMAS-4. A significant association was found between MMAS-8 scores and HbA1c levels. Using glycaemic control as a gold standard, sensitivity was 74.1% and specificity was 38.3%. Explanatory factor analysis identified three dimensions of the scale. In light of acceptable reliability and validity, the MMAS-8 is a simple and quick method for the assessment of medication adherence among patient with type 2 diabetes mellitus, in a busy clinic setting.

Relationship between viral load and self-report measures of medication adherence among youth with perinatal HIV infection

Poor adherence to antiretroviral therapy (ART) contributes to disease progression and emergence of drug-resistant HIV in youth with perinatally acquired HIV infection (PHIV +), necessitating reliable measures of adherence. Although electronic monitoring devices have often been considered the gold-standard assessment in HIV research, they are costly, can overestimate nonadherence and are not practical for routine care. Thus, the development of valid, easily administered self-report adherence measures is crucial for adherence monitoring. PHIV+youth aged 7–16 (n = 289) and their caregivers, enrolled in a multisite cohort study, were interviewed to assess several reported indicators of adherence. HIV-1 RNA viral load (VL) was dichotomized into >/≤400 copies/mL. Lower adherence was significantly associated with VL >400 copies/mL across most indicators, including ≥1 missed dose in past seven days [youth report: OR = 2.78 (95% CI, 1.46–5.27)]. Caregiver and combined youth/caregiver reports yielded similar results. Within-rater agreement between various adherence indicators was high for both youth and caregivers. Inter-rater agreement on adherence was moderate across most indicators. Age ≥13 years and living with biological mother or relative were associated with VL >400 copies/mL. Findings support the validity of caregiver and youth adherence reports and identify youth at risk of poor adherence.

GRP-027 Assessment of Blood Pressure Control and Antihypertensive Medication Adherence in a Portuguese Hypertensive Population

BackgroundHypertension is one of the major causes of worldwide morbidity and mortality. Despite the wide variety and availability of powerful antihypertensive agents, the blood pressure (BP) of fewer than a...

Medication-Taking Self-Efficacy and Medication Adherence Among HIV-Infected Cocaine Users

This prospective, observational study tested the ability of self-efficacy for taking antiretroviral medications to predict medication adherence among current and former cocaine and heroin users. Electronic monitors to record bottle openings and self-report measures of medication adherence were used. The sample included 99 men and women who were interviewed at 4-week intervals for 6 months. Mixed effects regression models to test the relationship of substance use and self-efficacy for medication-taking with percent of self-report adherence, dose adherence, number of days adherent, and adherence to medication schedule at each study visit showed that medication-taking self-efficacy was significantly related to all measures of adherence except schedule adherence. Findings also showed that electronically monitored adherence measures declined over the study period whereas self-report adherence did not. Findings suggest that self-efficacy can have a sustained effect on adherence to doses but may not be an influential predictor of adherence to their correct timing.

Psychometric Properties of Three Medication Adherence Scales in Patients With Rheumatoid Arthritis

Patient adherence to their health care protocols is important to encourage the best health outcomes in rheumatoid arthritis (RA); however, little attention has been given to assessing the psychometric properties of adherence measures in this patient population. The purpose of this study was to evaluate the psychometric properties of three existing self-report measures of medication adherence in a sample of patients with RA--the compliance-questionnaire-rheumatology (CQR), the Medication Adherence Report Scale (MARS), and the medication adherence scale (MAS). A cross-sectional study of 108 clinic patients with rheumatoid arthritis was conducted to evaluate the reliability and validity of the measures. Cronbach's alpha was .77 for both the CQR and a modified version of the MARS. For the MAS, the Kuder-Richardson 20 reliability was .25. Although not strong, test-retest reliability was adequate for all measures. Factor analysis indicated that both the MARS and the CQR measure two factors. All three instruments were moderately correlated with each other, with correlations ranging between .48 and .56. Although these scales were significantly correlated, moderate correlations among the scales indicate that they may not measure the same aspects of adherence. Among the three adherence measures, the modified MARS demonstrated the best evidence of reliability and validity and ease of administration in this sample of persons with RA.