Cargando…

Validation of the Adherence Barriers Questionnaire – an instrument for identifying potential risk factors associated with medication-related non-adherence

BACKGROUND: Medication non-adherence is a major challenge in the real-life treatment of chronically ill patients. To meet this challenge, adherence interventions with a tailored approach towards patient-specific adherence barriers that are identified with a reliable and practicable questionnaire are...

Descripción completa

Detalles Bibliográficos
Autores principales: Müller, Sabrina, Kohlmann, Thomas, Wilke, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422301/
https://www.ncbi.nlm.nih.gov/pubmed/25884193
http://dx.doi.org/10.1186/s12913-015-0809-0
_version_ 1782370035917914112
author Müller, Sabrina
Kohlmann, Thomas
Wilke, Thomas
author_facet Müller, Sabrina
Kohlmann, Thomas
Wilke, Thomas
author_sort Müller, Sabrina
collection PubMed
description BACKGROUND: Medication non-adherence is a major challenge in the real-life treatment of chronically ill patients. To meet this challenge, adherence interventions with a tailored approach towards patient-specific adherence barriers that are identified with a reliable and practicable questionnaire are needed. The aim of this investigation was to develop and validate such a questionnaire, the “Adherence Barriers Questionnaire (ABQ)”. METHODS: The German ABQ was developed and tested in 432 patients with atrial fibrillation in a multicentre observational cohort study. Evaluation of the questionnaire included an assessment of internal consistency as well as factor analysis. Criterion-related external validity was assessed by comparing the ABQ score with (1) the degree of self-reported adherence and (2) the time in therapeutic range which describes the anticoagulation quality achieved by patients treated with oral anticoagulation. RESULTS: The final 14-item ABQ scale demonstrated high internal consistency (Cronbach’s alpha = 0.820). Factor analysis identified a three-factor solution, representing intentional adherence barriers with 5 items (31.9% of the variance), medication-/health care system-related adherence barriers with 5 items (13.3% of the variance) and unintentional adherence barriers with 4 items (7.7% of the variance). The ABQ correlated significantly with self-reported non-adherence (Spearman’s rho = 0.438, p < 0.001) as well as time in therapeutic range (Spearman’s rho = − 0.161, p < 0.010). Patients with above-average ABQ scores (increased number and/or strength of existing adherence barriers) were significantly (p < 0.005, Pearson Chi-Square) more likely to have a poor anticoagulation quality (TTR < 60%) than patients with a lower ABQ score (44.6% versus 27.3%). CONCLUSIONS: The ABQ is a practicable, reliable and valid instrument for identifying patient-specific barriers to medication-related adherence. Future research is required to examine the ability of the ABQ to identify patient perception/behaviour changes over time which may be important for the measurement of success of adherence interventions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-015-0809-0) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-4422301
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-44223012015-05-07 Validation of the Adherence Barriers Questionnaire – an instrument for identifying potential risk factors associated with medication-related non-adherence Müller, Sabrina Kohlmann, Thomas Wilke, Thomas BMC Health Serv Res Research Article BACKGROUND: Medication non-adherence is a major challenge in the real-life treatment of chronically ill patients. To meet this challenge, adherence interventions with a tailored approach towards patient-specific adherence barriers that are identified with a reliable and practicable questionnaire are needed. The aim of this investigation was to develop and validate such a questionnaire, the “Adherence Barriers Questionnaire (ABQ)”. METHODS: The German ABQ was developed and tested in 432 patients with atrial fibrillation in a multicentre observational cohort study. Evaluation of the questionnaire included an assessment of internal consistency as well as factor analysis. Criterion-related external validity was assessed by comparing the ABQ score with (1) the degree of self-reported adherence and (2) the time in therapeutic range which describes the anticoagulation quality achieved by patients treated with oral anticoagulation. RESULTS: The final 14-item ABQ scale demonstrated high internal consistency (Cronbach’s alpha = 0.820). Factor analysis identified a three-factor solution, representing intentional adherence barriers with 5 items (31.9% of the variance), medication-/health care system-related adherence barriers with 5 items (13.3% of the variance) and unintentional adherence barriers with 4 items (7.7% of the variance). The ABQ correlated significantly with self-reported non-adherence (Spearman’s rho = 0.438, p < 0.001) as well as time in therapeutic range (Spearman’s rho = − 0.161, p < 0.010). Patients with above-average ABQ scores (increased number and/or strength of existing adherence barriers) were significantly (p < 0.005, Pearson Chi-Square) more likely to have a poor anticoagulation quality (TTR < 60%) than patients with a lower ABQ score (44.6% versus 27.3%). CONCLUSIONS: The ABQ is a practicable, reliable and valid instrument for identifying patient-specific barriers to medication-related adherence. Future research is required to examine the ability of the ABQ to identify patient perception/behaviour changes over time which may be important for the measurement of success of adherence interventions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-015-0809-0) contains supplementary material, which is available to authorized users. BioMed Central 2015-04-10 /pmc/articles/PMC4422301/ /pubmed/25884193 http://dx.doi.org/10.1186/s12913-015-0809-0 Text en © Müller et al.; licensee BioMed Central. 2015 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Müller, Sabrina
Kohlmann, Thomas
Wilke, Thomas
Validation of the Adherence Barriers Questionnaire – an instrument for identifying potential risk factors associated with medication-related non-adherence
title Validation of the Adherence Barriers Questionnaire – an instrument for identifying potential risk factors associated with medication-related non-adherence
title_full Validation of the Adherence Barriers Questionnaire – an instrument for identifying potential risk factors associated with medication-related non-adherence
title_fullStr Validation of the Adherence Barriers Questionnaire – an instrument for identifying potential risk factors associated with medication-related non-adherence
title_full_unstemmed Validation of the Adherence Barriers Questionnaire – an instrument for identifying potential risk factors associated with medication-related non-adherence
title_short Validation of the Adherence Barriers Questionnaire – an instrument for identifying potential risk factors associated with medication-related non-adherence
title_sort validation of the adherence barriers questionnaire – an instrument for identifying potential risk factors associated with medication-related non-adherence
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422301/
https://www.ncbi.nlm.nih.gov/pubmed/25884193
http://dx.doi.org/10.1186/s12913-015-0809-0
work_keys_str_mv AT mullersabrina validationoftheadherencebarriersquestionnaireaninstrumentforidentifyingpotentialriskfactorsassociatedwithmedicationrelatednonadherence
AT kohlmannthomas validationoftheadherencebarriersquestionnaireaninstrumentforidentifyingpotentialriskfactorsassociatedwithmedicationrelatednonadherence
AT wilkethomas validationoftheadherencebarriersquestionnaireaninstrumentforidentifyingpotentialriskfactorsassociatedwithmedicationrelatednonadherence