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Developing the Diagnostic Adherence to Medication Scale (the DAMS) for use in clinical practice
BACKGROUND: There is a need for an adherence measure, to monitor adherence services in clinical practice, which can distinguish between different types of non-adherence and measure changes over time. In order to be inclusive of all patients it needs to be able to be administered to both patients and...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507707/ https://www.ncbi.nlm.nih.gov/pubmed/23039138 http://dx.doi.org/10.1186/1472-6963-12-350 |
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author | Garfield, Sara Eliasson, Lina Clifford, Sarah Willson, Alan Barber, Nick |
author_facet | Garfield, Sara Eliasson, Lina Clifford, Sarah Willson, Alan Barber, Nick |
author_sort | Garfield, Sara |
collection | PubMed |
description | BACKGROUND: There is a need for an adherence measure, to monitor adherence services in clinical practice, which can distinguish between different types of non-adherence and measure changes over time. In order to be inclusive of all patients it needs to be able to be administered to both patients and carers and to be suitable for patients taking multiple medications for a range of clinical conditions. A systematic review found that no adherence measure met all these criteria. We therefore wished to develop a theory based adherence scale (the DAMS) and establish its content, face and preliminary construct validity in a primary care population. METHODS: The DAMS (consisting of 6 questions) was developed from theory by a multidisciplinary team and the questions were initially tested in small patient populations. Further to this, patients were recruited when attending a General Practice and interviewed using the DAMS and two other validated self-reported adherence measures, theMorisky-8 and Lu questionnaires. A semi-structured interview was used to explore acceptability and reasons for differences in responses between the DAMS and the other measures. Descriptive data were generated and Spearman rank correlation tests were used to identify associations between the DAMS and the other adherence measures. RESULTS: One hundred patients completed the DAMS in an average of 1 minute 28 seconds and reported finding it straightforward to complete. An adherence score could not be calculated for the 4(4%) patients only taking ‘when required’ medication. Thirty six(37.5%) of the remaining patients reported some non-adherence. Adherence ratings of the DAMS were significantly associated with levels of self reported adherence on all other measures Spearman Rho 0.348-0.719, (p < 0.01). Differences in trends could generally be explained by qualitative data. CONCLUSION: The DAMS has been developed for routine monitoring of adherence in clinical practice. It was acceptable to patients taking single or multiple medication and valid when tested against other adherence measures. However, ‘when required’ medication needs to be excluded. Further tests of the DAMS against objective measures such as MEMS are in progress and reliability needs to be established. Further investigation of the carers’ version of the DAMS is required. |
format | Online Article Text |
id | pubmed-3507707 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-35077072012-11-28 Developing the Diagnostic Adherence to Medication Scale (the DAMS) for use in clinical practice Garfield, Sara Eliasson, Lina Clifford, Sarah Willson, Alan Barber, Nick BMC Health Serv Res Research Article BACKGROUND: There is a need for an adherence measure, to monitor adherence services in clinical practice, which can distinguish between different types of non-adherence and measure changes over time. In order to be inclusive of all patients it needs to be able to be administered to both patients and carers and to be suitable for patients taking multiple medications for a range of clinical conditions. A systematic review found that no adherence measure met all these criteria. We therefore wished to develop a theory based adherence scale (the DAMS) and establish its content, face and preliminary construct validity in a primary care population. METHODS: The DAMS (consisting of 6 questions) was developed from theory by a multidisciplinary team and the questions were initially tested in small patient populations. Further to this, patients were recruited when attending a General Practice and interviewed using the DAMS and two other validated self-reported adherence measures, theMorisky-8 and Lu questionnaires. A semi-structured interview was used to explore acceptability and reasons for differences in responses between the DAMS and the other measures. Descriptive data were generated and Spearman rank correlation tests were used to identify associations between the DAMS and the other adherence measures. RESULTS: One hundred patients completed the DAMS in an average of 1 minute 28 seconds and reported finding it straightforward to complete. An adherence score could not be calculated for the 4(4%) patients only taking ‘when required’ medication. Thirty six(37.5%) of the remaining patients reported some non-adherence. Adherence ratings of the DAMS were significantly associated with levels of self reported adherence on all other measures Spearman Rho 0.348-0.719, (p < 0.01). Differences in trends could generally be explained by qualitative data. CONCLUSION: The DAMS has been developed for routine monitoring of adherence in clinical practice. It was acceptable to patients taking single or multiple medication and valid when tested against other adherence measures. However, ‘when required’ medication needs to be excluded. Further tests of the DAMS against objective measures such as MEMS are in progress and reliability needs to be established. Further investigation of the carers’ version of the DAMS is required. BioMed Central 2012-10-08 /pmc/articles/PMC3507707/ /pubmed/23039138 http://dx.doi.org/10.1186/1472-6963-12-350 Text en Copyright ©2012 Garfield et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Garfield, Sara Eliasson, Lina Clifford, Sarah Willson, Alan Barber, Nick Developing the Diagnostic Adherence to Medication Scale (the DAMS) for use in clinical practice |
title | Developing the Diagnostic Adherence to Medication Scale (the DAMS) for use in clinical practice |
title_full | Developing the Diagnostic Adherence to Medication Scale (the DAMS) for use in clinical practice |
title_fullStr | Developing the Diagnostic Adherence to Medication Scale (the DAMS) for use in clinical practice |
title_full_unstemmed | Developing the Diagnostic Adherence to Medication Scale (the DAMS) for use in clinical practice |
title_short | Developing the Diagnostic Adherence to Medication Scale (the DAMS) for use in clinical practice |
title_sort | developing the diagnostic adherence to medication scale (the dams) for use in clinical practice |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507707/ https://www.ncbi.nlm.nih.gov/pubmed/23039138 http://dx.doi.org/10.1186/1472-6963-12-350 |
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