Cited by 296Medication Adherence and ComplianceHIV/AIDS Research and InterventionsPharmacy and Medical Practices

Validation of a new three-item self-report measure for medication adherence

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Wilson, Ira B., Lee, Yoojin, Michaud, Joanne, Fowler, Floyd J., Rogers, William H.·2016·AIDS and Behavior

Abstract

Few self-report measures of medication adherence have been rigorously developed and validated against electronic drug monitoring (EDM). Assess the validity of the 3-item self-report scale by comparing it with a contemporaneous EDM measure. We conducted an observational study in which adherence assessments were done monthly for up to 4 months for 81 patients with HIV who were taking antiretroviral medications. We report results for both HIV antiretroviral medications, and also for other, non-HIV-related medications. Raw and calibrated self-report adherence measures, electronic drug monitoring adherence measures, and sociodemographic variables. The mean age of patients was 46 years, 37 % were female, 49 % had some education beyond high school, 22 % were Black, and 22 % were Hispanic. Cronbach's alphas for the 3-item scale for HIV and non-HIV medications were 0.83 and 0.87, respectively. The mean differences (raw/uncalibrated self-report scale minus EDM) for HIV and non-HIV medications were 7.5 and 5.2 points on a 100-point scale (p < 0.05 for both). Pearson correlation coefficients between the calibrated 3-item scale and the EDM for HIV and non-HIV medications were 0.47 and 0.59, respectively. The c-statistics for the ROC curves for the calibrated scale, using cut-offs of 0.8 and 0.9 for the EDM gold standard measure to define non-adherence, were between 0.74 and 0.76 for HIV and non-HIV medications. This 3-item adherence self-report scale showed good psychometric characteristics and good construct validity when compared with an EDM standard, for both HIV and non-HIV medications. In clinical care it can be a useful first-stage screener for non-adherence. In clinical research and quality improvement settings it can be a useful tool when more complex and expensive methods such as EDM or pharmacy claims are impractical or unavailable.

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Authors
Wilson, I. B., Lee, Y., Michaud, J., Fowler, F. J., & Rogers, W. H.
Affiliations
  • Brown University (US)
  • University of Massachusetts Boston (US)
  • Tufts Medical Center (US)
Corresponding author
Wilson, Ira B.
Venue
AIDS and Behavior
Published
2016-04-20
Volume
20
Issue
11
Pages
2700-2708
ISSN
  • 1090-7165 (ISSN-L)
  • 1573-3254
OpenAlex
W2340311148
Cited by
296
References
34
Citations by year
2026: 19 · 2025: 42 · 2024: 43 · 2023: 29 · 2022: 52 · 2021: 33 · 2020: 33 · 2019: 24 · 2018: 10 · 2017: 6 · 2016: 3 · 2013: 1
FWCI
17.47
Type
journal article
Language
en
Open access
Locations
  • AIDS and Behavior (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (RO1 MH 092238, 2K24MH092242)
Topics
  • Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
Keywords
medication adherence, HIV antiretroviral therapy, psychometric validation, adherence screening
MeSH terms
Adult, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Psychometrics, Surveys and Questionnaires, HIV Infections, Drug Monitoring, Anti-HIV Agents, Medication Adherence, Electronic Health Records, Self Report

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