Development and preliminary validation of the Adult Asthma Adherence Questionnaire™.
Development and preliminary validation of the Adult Asthma Adherence Questionnaire™.
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成人哮喘依从性问卷的开发和初步验证。
DOI：
10.1016/j.jaip.2013.03.001
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
Turner-Bowker,DianeM
中科院分区：
文献类型：
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作者：
Schatz,Michael;Zeiger,RobertS;Yang,Su-Jau;Weinstein,AndrewG;Chen,Wansu;Saris-Baglama,ReneeN;Turner-Bowker,DianeM
背景哮喘患者服药依从性与较好的哮喘转归有关，但在临床环境中识别次优患者依从性行为并不是标准化的。本研究的目的是开发一份实用的问卷，反映不依从性风险并识别潜在的依从性障碍。方法420名成人哮喘患者在过去6个月内填写了吸入性皮质类固醇(ICS)和短效β-激动剂(SABA)的处方，问卷包括20个潜在的依从性问题。没有实质性的地板或天花板效应的问题，与自我报告的低依从性或以前的ICS罐分配显著相关。采用克朗巴赫α进行内部一致性信度检验。确定了这些问题与哮喘控制测试分数、ICS治疗覆盖天数的未来百分比、未来哮喘加重和SABA治疗的关系。结果确定了五个最终问题：遵循“我的药物计划”、忘记、不“需要”药物、副作用和费用。内部一致性信度低(<；0.50)建议的条目不应用单一分数进行总结。所有五个问题都与哮喘控制测试分数有关。遵循药物治疗计划、忘记和不需要药物治疗与预期覆盖天数百分比显著相关。副作用与随后的SABA和口服皮质类固醇有关，成本与口服皮质类固醇显著相关。结论我们确定了5个与其他坚持措施和哮喘控制相关的问题，可用于临床识别不坚持的风险患者和涉及的特定坚持障碍。
BackgroundAsthma medication adherence is related to better asthma outcomes, but identification of suboptimal patient adherence behavior is not standardized in clinical settings.ObjectveThe purpose of this study was to develop a practical questionnaire that reflects nonadherence risk and identifies potential adherence barriers.MethodsA questionnaire that included 20 potential adherence questions was completed by 420 adult patients with asthma who filled a prescription for an inhaled corticosteroid (ICS) and a short-acting beta agonist (SABA) in the previous 6 months. Questions without substantial floor or ceiling effects that were significantly related to self-reported low adherence or previous ICS canister dispensings were identified. Internal consistency reliability was tested by Cronbach α. Relationships of these questions to Asthma Control Test scores, future percent of days covered for ICS dispensings, and future asthma exacerbations and SABA dispensings were determined.ResultsFive final questions were identified: following “my medication plan,” forgetting, not “needing” the medications, side effects, and cost. Low internal consistency reliability (<0.50) suggested items should not be summarized by a single score. All five questions were related to Asthma Control Test scores. Following the medication plan, forgetting, and not needing medication were significantly related to prospective percent of days covered. Side effects were related to subsequent SABA and oral corticosteroid dispensings, and cost was significantly related to oral corticosteroid dispensings.ConclusionsWe identified five questions related to other measures of adherence and to asthma control that can be used clinically to identify patients at risk of nonadherence and the specific adherence barriers involved.