Improving the measurement of self-reported medication nonadherence.
Improving the measurement of self-reported medication nonadherence.
复制标题
DOI：
10.1016/j.jclinepi.2010.07.014
复制
发表时间：
2011-03
影响因子：
7.2
通讯作者：
Yancy, William S., Jr.
中科院分区：
文献类型：
--
作者：
Voils, Corrine I.;Hoyle, Rick H.;Thorpe, Carolyn T.;Maciejewski, Matthew L.;Yancy, William S., Jr.
药物不依从性是慢性病管理中的一个重要临床问题。自我报告措施信度不高，分布性较差。我们展示了两个基本的测量问题如何限制了自我报告的药物不依从性措施的有效性，并提供了改进测量的建议。我们回顾了高血压患者中现有的自我报告用药不依从性的测量方法，高血压是最常见的慢性疾病之一，用药不依从性是最重要的问题。我们就两个问题对这些措施进行了评估：(1)因果指标(产生潜在结构)和效果指标(由潜在结构决定)的合并，以及(2)缺乏关于不遵守随时间变化的稳定性的证据。通过使用效果指标来评估不遵守的程度，并使用因果指标来评估不遵守的原因，可以改进不遵守的测量。此外，应对药物不依从性进行纵向评估，以便统计模型的最新发展可以阐明药物不依从性在多大程度上是暂时性的，而不是稳定性的。对这些测量问题的关注可以改善对自我报告的不依从性的评估，从而允许对服药行为得出更准确的结论，并为针对药物不依从性的改进干预措施的发展提供信息。
Medication nonadherence is a significant clinical problem in chronic disease management. Self-report measures have inadequate reliability and poor distributional properties. We demonstrate how two fundamental measurement issues have limited the usefulness of self-reported medication nonadherence measures and offer recommendations for improving measurement. We reviewed existing self-report measures of medication nonadherence in the context of hypertension, one of the most common chronic conditions in which medication nonadherence is a paramount concern. We evaluated these measures with regard to two issues: (1) conflation of causal indicators (which give rise to a latent construct) and effect indicators (which are determined by a latent construct), and (2) a lack of evidence regarding the stability of nonadherence over time. Nonadherence measurement could be improved by using effect indicators to assess the extent of nonadherence and causal indicators to assess reasons for nonadherence. Moreover, nonadherence should be assessed longitudinally, so that recent developments in statistical modeling can illuminate the extent to which medication nonadherence is transient vs. stable. Attention to these measurement issues can improve the assessment of self-reported nonadherence, thereby allowing more accurate conclusions to be drawn about medication-taking behavior and informing the development of improved interventions that target medication nonadherence.
登录
查看更多内容
影响因子：
5.9
作者：
KENNY, DA;ZAUTRA, A
通讯作者：
ZAUTRA, A
影响因子：
7
作者：
Courvoisier, Delphine S.;Eid, Michael;Nussbeck, Fridtjof W.
通讯作者：
Nussbeck, Fridtjof W.
影响因子：
22.4
作者：
BOLLEN, K;LENNOX, R
通讯作者：
LENNOX, R
影响因子：
120.7
作者：
Spitzer, RL;Kroenke, K;Williams, JBW
通讯作者：
Williams, JBW
影响因子：
22.4
作者：
MACCALLUM, RC;BROWNE, MW
通讯作者：
BROWNE, MW