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

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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

DOI 10.1007/s10461-016-1406-xPMC PMC5071118

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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.
ORCID: Wilson, Ira B.
Lee, Yoojin
Fowler, Floyd J.
Venue: AIDS and Behavior
Publisher: Springer Science and Business Media LLC
Published: 2016-04-20
Volume: 20
Issue: 11
Pages: 2700-2708
ISSN: 1090-7165 (ISSN-L)
1573-3254
DOI: 10.1007/s10461-016-1406-x
PMC: PMC5071118
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
FWCI: 17.47
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
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
Health Sciences › Health Professions › Pharmacy › 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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Validation of a New Three-Item Self-Report Measure for Medication Adherence

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