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Validation of a New Three-Item Self-Report Measure for Medication Adherence
Open accessAbstract
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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“previous research has shown that SLWH may have difficulties with ART uptake.65–67”
From Evaluation of an integrated treatment to address smoking cessation and anxiety/depressive symptoms among people living with HIV: Study protocol for a randomized controlled trial (2021) · cites this paper as [65]
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“Although we used an item from a validated scale [26], self-reported ART adherence tends to over-estimate adherence.”
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Metadata
- 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
- 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
- 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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