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Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs
Background: The biologic disease-modifying antirheumatic drugs (bDMARDs) are currently incorporated as part of the pharmacotherapy management of inflammatory arthritis (IA). Adherence to bDMARDs is crucial to ensure treatment success in IA. However, most of the recent studies evaluated adherence lev...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7681069/ https://www.ncbi.nlm.nih.gov/pubmed/33240088 http://dx.doi.org/10.3389/fphar.2020.572260 |
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author | Abdul Razak, Salmi Makmor Bakry, Mohd Mohamed Said, Mohd Shahrir Tan, Chai-Eng Md Redzuan, Adyani |
author_facet | Abdul Razak, Salmi Makmor Bakry, Mohd Mohamed Said, Mohd Shahrir Tan, Chai-Eng Md Redzuan, Adyani |
author_sort | Abdul Razak, Salmi |
collection | PubMed |
description | Background: The biologic disease-modifying antirheumatic drugs (bDMARDs) are currently incorporated as part of the pharmacotherapy management of inflammatory arthritis (IA). Adherence to bDMARDs is crucial to ensure treatment success in IA. However, most of the recent studies evaluated adherence level in patients using subcutaneous injections of bDMARDs utilized the indirect methods adapted from adherence assessment for oral medication. Aim: This study aimed to develop a questionnaire to assess adherence to the self-injectable subcutaneous bDMARDs. Methods: The development of the Subcutaneous bDMARDs Adherence Score (SCADS) involved evaluation of content validity. Literature reviews provide the basis for domain identification and item formation. Four experts evaluated the instrument by using a four-point ordinal scale with a rubric scoring on relevance, importance, and clarity of each item in measuring the overarching construct. The item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI) were calculated. The factor structure and internal consistency reliability of SCADS were estimated using principal component analysis (PCA) and Cronbach’s alpha, respectively. Results: Both S-CVI/UA (universal agreement) and the average item-level content validity index (S-CVI/Ave) (average) for the entire instrument showed excellent criteria with a value of >0.90. Cronbach’s alpha coefficient value for SCADS was 0.707 indicating good internal consistency. All items showed corrected item-total correlation coefficients above 0.244. Questionnaire items with a factor loading of 0.30 or above were considered in the final factor solution. The factor analysis resulted in 3-factor solutions, which corresponded to 66.62% of the total variance. Conclusion: The SCADS is a consistent and reliable instrument for evaluating adherence among IA patients using the subcutaneous bDMARDs. It is simple to use, yet comprehensive but still requiring further clinical and international validation. |
format | Online Article Text |
id | pubmed-7681069 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76810692020-11-24 Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs Abdul Razak, Salmi Makmor Bakry, Mohd Mohamed Said, Mohd Shahrir Tan, Chai-Eng Md Redzuan, Adyani Front Pharmacol Original Research Background: The biologic disease-modifying antirheumatic drugs (bDMARDs) are currently incorporated as part of the pharmacotherapy management of inflammatory arthritis (IA). Adherence to bDMARDs is crucial to ensure treatment success in IA. However, most of the recent studies evaluated adherence level in patients using subcutaneous injections of bDMARDs utilized the indirect methods adapted from adherence assessment for oral medication. Aim: This study aimed to develop a questionnaire to assess adherence to the self-injectable subcutaneous bDMARDs. Methods: The development of the Subcutaneous bDMARDs Adherence Score (SCADS) involved evaluation of content validity. Literature reviews provide the basis for domain identification and item formation. Four experts evaluated the instrument by using a four-point ordinal scale with a rubric scoring on relevance, importance, and clarity of each item in measuring the overarching construct. The item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI) were calculated. The factor structure and internal consistency reliability of SCADS were estimated using principal component analysis (PCA) and Cronbach’s alpha, respectively. Results: Both S-CVI/UA (universal agreement) and the average item-level content validity index (S-CVI/Ave) (average) for the entire instrument showed excellent criteria with a value of >0.90. Cronbach’s alpha coefficient value for SCADS was 0.707 indicating good internal consistency. All items showed corrected item-total correlation coefficients above 0.244. Questionnaire items with a factor loading of 0.30 or above were considered in the final factor solution. The factor analysis resulted in 3-factor solutions, which corresponded to 66.62% of the total variance. Conclusion: The SCADS is a consistent and reliable instrument for evaluating adherence among IA patients using the subcutaneous bDMARDs. It is simple to use, yet comprehensive but still requiring further clinical and international validation. Frontiers Media S.A. 2020-11-09 /pmc/articles/PMC7681069/ /pubmed/33240088 http://dx.doi.org/10.3389/fphar.2020.572260 Text en Copyright © 2020 Abdul Razak, Makmor Bakry, Mohamed Said, Chai Eng and Md Redzuan http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Original Research Abdul Razak, Salmi Makmor Bakry, Mohd Mohamed Said, Mohd Shahrir Tan, Chai-Eng Md Redzuan, Adyani Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs |
title | Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs |
title_full | Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs |
title_fullStr | Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs |
title_full_unstemmed | Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs |
title_short | Development and Validation of Adherence Score for Subcutaneous Biologic Disease-Modifying Antirheumatic Drugs |
title_sort | development and validation of adherence score for subcutaneous biologic disease-modifying antirheumatic drugs |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7681069/ https://www.ncbi.nlm.nih.gov/pubmed/33240088 http://dx.doi.org/10.3389/fphar.2020.572260 |
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