Development and evaluation of a self-report tool to predict low pharmacy refill adherence in elderly patients with uncontrolled hypertension.
Development and evaluation of a self-report tool to predict low pharmacy refill adherence in elderly patients with uncontrolled hypertension.
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DOI：
10.1002/phar.1275
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发表时间：
2013-08
期刊：
影响因子：
4.1
通讯作者：
Muntner, Paul
中科院分区：
文献类型：
--
作者：
Krousel-Wood, Marie;Joyce, Cara;Holt, Elizabeth W.;Levitan, Emily B.;Dornelles, Adriana;Webber, Larry S.;Muntner, Paul
开发和评估一个简短的自我报告工具，通过使用老年高血压患者的药房续药数据来预测低药房续药依从性。对老年人药物依从性队列研究（CoSMO）的调查和管理数据进行横断面分析。394例血压不受控制的成人;平均± SD年龄为76.6 ± 5.6岁，33.0%为黑人，66.0%为女性，23.4%的药物拥有率（MPR）较低。我们考虑了164个自我报告的候选项目，用于根据药房再填充数据制定低（< 0.8）与高（≥ 0.8）MPR的预测规则。通过使用最佳子集分析评估风险预测模型，并基于临床相关性和模型简约性选择最终模型。Bootstrap模拟评估内部效度。将最终4项模型的性能与8项Morisky药物依从性量表（MMAS-8）和9项Hill-Bone依从性量表进行比较。用于预测药房续药依从性的4项自我报告工具显示出中等区分度（C统计量0.704，95%CI 0.683-0.714）和良好的模型拟合（Hosmer-Lemeshow χ2 = 1.238，p=0.743）。敏感性和特异性分别为67.4%和67.8%。MMAS-8和Hill-Bone顺应性量表的C统计量较低，分别为0.665（95% CI 0.632-0.683）和0.660（95% CI 0.622-0.674）。一个4项自我报告工具适度区分低从高药房再填充坚持者，其测试性能与现有的8项和9项坚持量表。简约的自我报告工具预测低药房补充患者血压不受控制，可以促进老年人的高血压管理。
To develop and evaluate a short self-report tool to predict low pharmacy refill adherence by using pharmacy refill data in older patients with uncontrolled hypertension. Cross-sectional analysis of survey and administrative data data from the Cohort Study of Medication Adherence among Older Adults (CoSMO). Three hundred ninety-four adults with uncontrolled blood pressure; mean ± SD age was 76.6 ± 5.6 years, 33.0% were black, 66.0% were women, and 23.4% had a low medication possession ratio (MPR). We considered 164 self-reported candidate items for development of a prediction rule for low (< 0.8) vs. high (≥ 0.8) MPR from pharmacy refill data. Risk prediction models were evaluated by using best subsets analyses, and the final model was chosen based on clinical relevance and model parsimony. Bootstrap simulations assessed internal validity. The performance of the final 4-item model was compared to the 8-item Morisky Medication Adherence Scale (MMAS-8) and the 9-item Hill-Bone Compliance Scale. The 4-item self-report tool for predicting pharmacy refill adherence showed moderate discrimination (C statistic 0.704, 95% CI 0.683–0.714) and good model fit (Hosmer-Lemeshow χ2 = 1.238, p=0.743). Sensitivity and specificity were 67.4% and 67.8%, respectively. The C statistics for MMAS-8 and the Hill-Bone Compliance Scale were lower at 0.665 (95% CI 0.632–0.683) and 0.660 (95% CI 0.622–0.674), respectively. A 4-item self-report tool moderately discriminated low from high pharmacy refill adherers, and its test performance was comparable to existing 8- and 9-item adherence scales. Parsimonious self-report tools predicting low pharmacy refill in patients with uncontrolled blood pressure could facilitate hypertension management in the elderly.
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
4.8
作者：
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影响因子：
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DOI：
10.1111/j.1532-5415.2009.02639.x
发表时间：
2010-01-01
影响因子：
6.3
作者：
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通讯作者：
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影响因子：
120.7
作者：
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