Treatment Adherence Questionnaire Research Articles

Valoración de la calidad de vida, estigma social y adhesión al tratamiento en pacientes con epilepsia del Área de Salud de Cáceres: estudio transversal

Epilepsy is a chronic disease with high prevalence. Its impact in the quality of life is influenced by factors like disease characteristics, comorbidities, stigma perception and treatment adherence. To assess the quality of life, the social stigma and the treatment adherence of patients with epilepsy in our area. Descriptive, observational and cross-sectional study. Sociodemographic and clinical data were collected. We analyzed data on quality of life (QUOLIE-10), social stigma and treatment adherence through different questionnaires. 40 patients were studied. The mean age was 42.43 ± 17.20 years, and the onset of epilepsy was 25.88 ± 16.81 years. 55% were women. The score in the quality of life questionnaire was 19.28 ± 8.03 points in men and 17.00 ± 7.69 for women, this difference being not significant. There were also no significant differences for social stigma, with a mean of 11.50 ± 13.47 points in men and 6.00 ± 10.36 points for women (p = 0.152). According to the treatment adherence questionnaire (Morisky-Green), 70% of the patients studied were compliant with the treatment. Patients with epilepsy in our environment have a good quality of life, probably related to good treatment adherence and compliance. There is low perceived social stigma but people with epilepsy still trend to hide their condition.

Effect of Reminder Cards on Adherence to Treatment in Patients with Uncontrolled Hypertension

Hypertension is one of the most important risk factors of cardiovascular diseases. In developing countries like Iran, the prevalence of hypertension is expanding. Today, the use of new technologies such as reminder cards, as a tool for promoting adherence to treatment, is recommended. The present research aimed to evaluate reminder cards on adherence to treatment in the patients with hypertension, who were referred to Seyed al Shohada Medical and Educational Center, Urmia, Iran. Methods: The present work was a clinical trial study, in which 82 patients with hypertension that were referred to Seyedal Shohada Medical and Educational Center, Urmia, Iran, and had the inclusion criteria were selected using the convenience sampling method. Then, they were randomly assigned to two groups, including those trained with reminder cards, and the control group. The data collection tool included demographic questionnaire and Hill-Ben's treatment adherence questionnaire, which was filled via two steps before and after the intervention. During the 12-week follow-up course, for the reminder cards group, the correct manner and sequence of using reminder cards was trained to the patients and their families. Data analysis was performed with SPSS 16 software using descriptive and inferential tests. Results: Results of this study demonstrated that mean score of adherence to treatment advice among the patients was not statistically different in the two groups before the intervention (P > 0.05). However, mean scores of adherence to treatment advice was statistically different in the two groups after the intervention (P = 0.000). Conclusions: Findings obtained from the present research demonstrated that training and remote follow-up via remainder cards leads to adherence promotion of patients to treatment advice. Therefore, healthcare teams and nurses of these patients are recommended to apply such training methods.

Effect of Motivational Interviewing on Adherence to Treatment in Patients with Hypertension

Aims: Hypertension is one of the most common chronic diseases all around the world and majority of hypertensive patients suffer from hypertension problems due to lack of treatment adherence. The current study aimed to investigate the effect of motivational interviewing on adherence to treatment in patients with hypertension and its comparison with standard cares. Materials & Methods: This randomized clinical trial was done during February to October 2014. In total, 140 of hypertensive patients were selected using multi-stage cluster sampling method from two urban health centers located in Gorgan City, Iran, with regards to the inclusion criteria and allocated randomly into two groups; motivational interviewing (70 participants) and control (70 participants). Data collecting instruments were demographic questionnaire (personal information, laboratory indices and clinical symptoms), general selfefficacy scale and treatment adherence questionnaire of patients with hypertension. Data were analyzed in SPSS 18 software using paired T and Independent T tests. Findings: Motivational interviewing increased total score and the mean score of all dimensions of the adherence questionnaire (except for weight control and stress reduction) (p<0.05). After 6 month, systolic blood pressure and diastolic blood pressure also decreased significantly in the motivational interviewing group (p<0.05). Conclusion: Motivational interviewing is likely beneficial to improve and promote medication adherence and blood pressure control in patients with hypertension.

Identification of validated questionnaires to measure adherence to pharmacological antihypertensive treatments.

BackgroundLow adherence to pharmacological treatments is one of the factors associated with poor blood pressure control. Questionnaires are an indirect measurement method that is both economic and easy to use. However, questionnaires should meet specific criteria, to minimize error and ensure reproducibility of results. Numerous studies have been conducted to design questionnaires that quantify adherence to pharmacological antihypertensive treatments. Nevertheless, it is unknown whether questionnaires fulfil the minimum requirements of validity and reliability. The aim of this study was to compile validated questionnaires measuring adherence to pharmacological antihypertensive treatments that had at least one measure of validity and one measure of reliability.MethodsA literature search was undertaken in PubMed, the Excerpta Medica Database (EMBASE), and the Latin American and Caribbean Health Sciences Literature database (Literatura Latino-Americana e do Caribe em Ciências da Saúde [LILACS]). References from included articles were hand-searched. The included papers were all that were published in English, French, Portuguese, and Spanish from the beginning of the database’s indexing until July 8, 2013, where a validation of a questionnaire (at least one demonstration of the validity and at least one of reliability) was performed to measure adherence to antihypertensive pharmacological treatments.ResultsA total of 234 potential papers were identified in the electronic database search; of these, 12 met the eligibility criteria. Within these 12 papers, six questionnaires were validated: the Morisky–Green–Levine; Brief Medication Questionnaire; Hill-Bone Compliance to High Blood Pressure Therapy Scale; Morisky Medication Adherence Scale; Treatment Adherence Questionnaire for Patients with Hypertension (TAQPH); and Martín–Bayarre–Grau. Questionnaire length ranged from four to 28 items. Internal consistency, assessed by Cronbach’s α, varied from 0.43 to 0.889. Additional statistical techniques utilized to assess the psychometric properties of the questionnaires varied greatly across studies.ConclusionAt this stage, none of the six questionnaires included could be considered a gold standard. However, this revision will assist health professionals in the selection of the most appropriate tool for their individual circumstances.

Toward a cultural adaptation of pharmacotherapy: Latino views of depression and antidepressant therapy.

Relative to non-Latino Whites, Latinos in the United States with major depressive disorder (MDD) show low engagement in antidepressant therapy, whether engagement is defined as pharmacotherapy access, medication initiation, pill-taking, or treatment retention. One potential reason for this disparity in depression care is the low cultural congruence of pharmacotherapy for this population. To examine Latinos' views of depression and antidepressant therapy, we conducted qualitative interviews with 30 Latino outpatients initiating antidepressants prior to their first treatment visit using the semistructured Treatment Adherence and Retention Questionnaire. These baseline interviews were randomly selected from data collected for a randomized controlled trial testing a novel intervention to enhance engagement by depressed Latino outpatients. Participant narratives were analyzed using open coding and the iterative analytical approach derived from grounded theory. Patient views about depression addressed stigmatizing views held by others in their social circle. Most participants directly refuted these views by providing alternate explanations to depression experiences. Antidepressant therapy narratives also revealed marked stigmatization, but participants tended not to refute these views. Instead, patients expressed concerns about antidepressants and showed marked ambivalence about seeking psychiatric care. Participants, however, did suggest ways in which clinicians and patients might collaborate to address their concerns about antidepressants. Some cultural views, such as concerns about addiction to or dependence on medication, may be negotiable barriers to treatment. Prescribing clinicians should address cultural views and concerns in order to improve Latino engagement in antidepressant therapy.

Initial evaluation of the Parent Cystic Fibrosis Questionnaire—Revised (CFQ-R) in infants and young children

BackgroundThere is an urgent need to evaluate treatments for young children with cystic fibrosis (CF); however, efforts have been hampered by a lack of reliable, practical endpoints. To examine whether a patient-reported outcome could be reliable in children 4 to 60months of age, we assessed the psychometric properties of the modified Parent Cystic Fibrosis Questionnaire—Revised (CFQ-R) using data from the Infant Study of Inhaled Saline (ISIS). We also characterized patterns of symptom presentation and daily functioning in children in this age range to inform future measure development. MethodsParents (N=314) completed the CFQ-R and Treatment Adherence Questionnaire (TAQ) at five quarterly visits, as well as a weekly Parent Symptom Diary. ResultsThe Parent CFQ-R demonstrated good construct validity and adequate internal consistency (α's .58–.75). Associations with age, TAQ, and Parent Symptom Diary were observed. The Treatment Burden scale demonstrated responsiveness to change. ConclusionsParents were reliable observers of young children's symptoms and daily functioning, and PROs show promise for this age group. Research is needed to identify key symptoms in infants and young children with CF, and to develop a parent proxy PRO according to FDA/EMA guidelines.

La relación entre adherencia terapéutica y calidad de vida en la hipertensión arterial

Arterial hypertension is a major risk factor for cardiovascular disease, and it is estimated that around 20% of the world population is affected. Treatment involves both intake of prescribed medicine and changes in patient's lifestyle. Lack of adherence to treatment has been identified as a main factor in its maintenance. Although exact measurement of treatment adherence is difficult, it is reckoned that around half the patients are considered non-adherent. The present study's aim was to evaluate the relationship be- tween health related quality of life (HRQL) and treatment compliance in patients with a diagnosis of arterial hypertension. Sample was 127 subjects (94 feminine) undergoing treatment. The Short Form-36 Healthy Survey (SF-36), and the Treatment Adherence Questionnaire for cases of Arterial Hypertension (Caceres, Arrivillaga, Correa, Holguin & Varela, 2006) were used. A statistically significant and positive correlation (p< 0.05) was found between all SF-36 scales and Treatment Adherence. Results propose treatment adherence as a fundamental component of hypertensive treatment, given that enhancement of patient's subjective perception of their general health would positively reinforce medical treatment and compliance with healthy behavior.

Adesão ao Tratamento em Gestação de Alto Risco

No Brasil, aproximadamente 15% das gestações são de alto risco, sendo os diagnósticos de diabetes gestacional e hipertensão as causas mais frequentes dessa condição. Para a efetividade dos tratamentos indicados nesses casos, bem como alcance de desfechos favoráveis, é essencial a adesão da paciente às recomendações fornecidas pelas equipes de saúde, o que torna fundamental a avaliação desse indicador. A pesquisa apresentada avaliou a adesão de participantes de um programa de atendimento interdisciplinar a gestantes de alto risco desenvolvido em um hospital geral privado por meio de três instrumentos: Questionário Morisky-Green de adesão ao uso de medicação, Questionário de Adesão ao Tratamento e Pergunta descritiva de avaliação qualitativa. Durante oito meses, 83 gestantes responderam aos questionários, que possibilitaram identificar níveis de adesão ao longo do tempo de participação no programa, situações de não adesão mais frequentes, bem como variáveis que interferem nas medidas de adesão ao uso de medicação e ao tratamento global. Considera-se que os índices levantados são passíveis de uso como indicadores clínicos e gerenciais, possibilitando a comprovação da efetividade e melhoria constante das rotinas de saúde. Tais mecanismos são úteis para definição de protocolos, discussão de casos clínicos e mesmo para feedbackàs próprias pacientes.

Development and psychometric evaluation of the Treatment Adherence Questionnaire for Patients with Hypertension

This article is a report of the development and psychometric testing of the Treatment Adherence Questionnaire for Patients with Hypertension. Hypertension is the most prevalent health problem among adult patients affecting approximately 200 million people in China and about 1 billion persons worldwide. Adherence to medication and lifestyle for hypertensive patients result in blood pressure control and reduce adverse outcomes. At present, few specific adherence instruments are available to completely evaluate medication and lifestyle for hypertensive patients. A multi-phase psychometric questionnaire development method was used to develop the instrument. The item pool was generated using literature review and focus group. Content validity was evaluated by expert panel. Then, the field testing was conducted by a convenience sampling of 278 hypertensive patients from December 2009 to May 2010 in Guangdong Province of China. Exploratory and confirmatory factor analyses were used to test construct validity. Finally, internal consistency and test-retest reliability were assessed. The new measure consisted of six dimensions with 28 items, explaining 62·54% of the total variance in the data. Confirmative factor analysis supported a good overall fit of the six-factor model. Cronbach's α of the overall questionnaire was 0·86 and 0·82 for test-retest reliability. The questionnaire was a brief and psychometrically sound instrument to evaluate hypertensive patients' treatment adherence and to be applied in the research and clinical fields.

Use of an Online Community to Develop Patient-Reported Outcome Instruments: The Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ)

Background Patients with multiple sclerosis (MS) may face barriers, such as treatment fatigue, memory problems, or side effects, that may influence their adherence to medication.Objective The objective of our study was to use an online community to develop a self-report questionnaire to quantify adherence and barriers to achieving adherence, that is specific to MS disease-modifying treatments (DMTs) and predictive of missed doses.Methods A review of the scientific literature and analysis of discussions between MS patients on PatientsLikeMe.com were used to generate survey items salient to patients. Cognitive debriefing was used to refine the items. The Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) contains 30 questions in three subscales: Barriers, Side Effects, and Coping Strategies.Results MS patients completed an online survey (response rate: 431 of 1209 invited, 35.7%). Between 16% (14/86) and 51% (51/100) of MS patients missed at least 1 dose of their DMT in the previous 28 days, with significant between-treatment differences. The MS-TAQ Barriers scale was positively correlated with the proportion of doses missed (r = .5), demonstrating a stronger relationship between adherence and perceived barriers than was found with clinical or demographic variables (r ≈ .3). The Coping Strategies subscale was negatively correlated with missed doses (r = -.3), suggesting that use of more coping strategies is associated with higher adherence.Conclusions Online communities can provide domains of interest and psychometric data to more rapidly develop and prototype patient-reported outcome instruments. The MS-TAQ offers patients and clinicians a simple method for identifying barriers to adherence, which may then be targeted through interventions.

Preliminary Validity of the Barriers to Treatment Adherence Questionnaire in Fibromyalgia: Combining Quantitative and Focus Group Data

The goals of this study were to (1) provide preliminary reliability and validity of the Barriers to Treatment Adherence Questionnaire, developed for patients with fibromyalgia, and (2) examine barriers to adherence and general adherence to multimodal treatment during a 3-mo. period. A secondary goal was to explore in a focus discussion group format patients' perceptions of the adherence process and ways of managing the treatment program. 39 fibromyalgia patients were followed while participating in a combined outpatient program of physiotherapy, occupational therapy, nursing, and cognitive behavioral therapy. The Barriers to Treatment Adherence Questionnaire demonstrated good reliability. Construct validity of the Barriers to Treatment Adherence Questionnaire was supported through significant positive correlations with the General Adherence Scale at Months 1 and 3. In addition, a significant change was observed in scores on the Barriers to Treatment Adherence Questionnaire for the physiotherapy component of treatment, with scores decreasing between Months 2 and 3. Addressing barriers to improve adherence may maximize the benefit of treatment programs.