The DOI matches its Crossref record; 4 of the 4 references it cites were found in a registry or an index.
Are two commonly used self-report questionnaires useful for identifying antihypertensive medication nonadherence?
Open accessAbstract
OBJECTIVE: Medication nonadherence is a major cause of uncontrolled hypertension, but clinicians are poor at judging adherence, and the gold standard for measuring adherence, electronic monitoring, is rarely available in clinical settings. Self-report questionnaires (SRQs), by contrast, are inexpensive, easy to administer, and hence, may be useful for 'diagnosing' nonadherence. In this study, we evaluated the validity of two commonly used medication adherence SRQs among patients with uncontrolled hypertension, using electronic pillbox measurement as the gold standard. METHODS: A total of 149 patients with uncontrolled hypertension had adherence to their antihypertensive medication regimen monitored using a four-compartment electronic pillbox (MedSignals) between two primary care visits (median 50 days). Participants completed the 8-item Morisky Medication Adherence Scale (MMAS-8) and the Visual Analog Scale (VAS) at the second visit. Likelihood ratios were calculated using less than 80% correct dosing adherence by electronic measurement as the gold standard. RESULTS: SRQ scores indicating low adherence (MMAS-8 <6 and VAS <80%, 23 and 9% of participants, respectively) had likelihood ratios of 2.00 [95% confidence interval (CI) 1.10-3.65] and 7.72 (95% CI 1.77-33.6), respectively, for detecting nonadherence compared to electronic measurement. SRQ scores indicating highest adherence (MMAS-8 = 8 and VAS = 100%, 43 and 61% of participants, respectively) had likelihood ratios of 0.55 (95% CI 0.35-0.85) and 0.76 (95% CI 0.57-1.01), respectively, for detecting nonadherence. CONCLUSION: The MMAS-8 and VAS are modestly useful in identifying antihypertensive medication nonadherence. Other tools, including electronic measurement, may be needed to guide titration of antihypertensive medications among patients with uncontrolled hypertension.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“MEMS results have been compared to patients’ and clinicians’ reports with weak to moderate correlation[28–30].”
From Adherence is associated with a favorable outcome after lung transplantation (2019) · cites this paper as [30]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Patients tend to overestimate their adherence in self-reports with a self-reported adherence rate of 75–90%, while electronic measurements indicated adherence in less than 60% of patients[30].”
From Adherence is associated with a favorable outcome after lung transplantation (2019) · cites this paper as [30]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
1 retracted
Retracted: Predictive Validity of a Medication Adherence Measure in an Outpatient Setting
Morisky, D. E., Ang, A., Krousel‐Wood, M., & Ward, H. J. (2008) · The Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2008.07572.x · Cited by 2,877
RetractedDiMatteo, M. R. (2004) · Medical Care · doi:10.1097/01.mlr.0000114908.90348.f9 · Cited by 2,169
Likelihood ratios with confidence: Sample size estimation for diagnostic test studies
Simel, D. L., Samsa, G. P., & Matchar, D. B. (1991) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(91)90128-v · Cited by 932 · cited 1×
“were used to calculate 95% confidence intervals (CIs) for each of these estimates [29].”
MethodAutomated Hovering in Health Care — Watching Over the 5000 Hours
Asch, D. A., Muller, R. W., & Volpp, K. G. (2012) · New England Journal of Medicine · doi:10.1056/nejmp1203869 · Cited by 193
Research works printed but not linked: 33
- Chobanian, 2009, Shattuck lecture. The hypertension paradox: more uncontrolled disease despite improved therapy., N Engl J Med, 361, 878, 10.1056/NEJMsa0903829 · DOI
- Egan, 2010, US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008., JAMA, 303, 2043, 10.1001/jama.2010.650 · DOI · Paper page
- Go, 2014, Heart disease and stroke statistics: 2014 update: a report from the American Heart Association., Circulation, 129, e28
- James, 2014, 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8)., JAMA, 311, 507, 10.1001/jama.2013.284427 · DOI · Paper page
- Bramley, 2006, Relationship of blood pressure control to adherence with antihypertensive monotherapy in 13 managed care organizations., J Manag Care Pharm, 12, 239, 10.18553/jmcp.2006.12.3.239 · DOI · Paper page
- Ho, 2008, Importance of therapy intensification and medication nonadherence for blood pressure control in patients with coronary disease., Arch Intern Med, 168, 271, 10.1001/archinternmed.2007.72 · DOI
- Kerr, 2008, The role of clinical uncertainty in treatment decisions for diabetic patients with uncontrolled blood pressure., Ann Intern Med, 148, 717, 10.7326/0003-4819-148-10-200805200-00004 · DOI
- Turner, 2001, Improving on a coin toss to predict patient adherence to medications., Ann Intern Med, 134, 1004, 10.7326/0003-4819-134-10-200105150-00015 · DOI · Paper page
- Miller, 2002, How well do clinicians estimate patients adherence to combination antiretroviral therapy J Gen Intern M, ed, 17, 1
- Mushlin, 1977, Diagnosing potential noncompliance: physicians ability in a behavioral dimension of medical care., Arch Intern Med, 137, 318, 10.1001/archinte.1977.03630150030010 · DOI
- Zeller, 2008, Physicians ability to predict patients adherence to antihypertensive medication in primary care., Hypertens Res, 31, 1765, 10.1291/hypres.31.1765 · DOI
- Osterberg, 2005, Adherence to medication., N Engl J Med, 353, 487, 10.1056/NEJMra050100 · DOI · Paper page
- Zeller, 2008, Patients self-reported adherence to cardiovascular medication using electronic monitors as comparators., Hypertens Res, 31, 2037, 10.1291/hypres.31.2037 · DOI
- Prado, 2007, Validity of four indirect methods to measure adherence in primary care hypertensives., J Hum Hypertens, 21, 579, 10.1038/sj.jhh.1002196 · DOI
- Choo, 1999, Validation of patient reports, automated pharmacy records, and pill counts with electronic monitoring of adherence to antihypertensive therapy., Med Care, 37, 846, 10.1097/00005650-199909000-00002 · DOI
- Schroeder, 2006, Adherence to antihypertensive medication assessed by self-report was associated with electronic monitoring compliance., J Clin Epidemiol, 59, 650, 10.1016/j.jclinepi.2005.10.013 · DOI
- Shalansky, 2004, Self-reported Morisky score for identifying nonadherence with cardiovascular medications., Ann Pharmacother, 38, 1363, 10.1345/aph.1E071 · DOI
- Inui, 1981, Screening for noncompliance among patients with hypertension: is self-report the best available measure Med C, are, 19, 1061
- Zeller, 2008, An adherence self-report questionnaire facilitated the differentiation between nonadherence and nonresponse to antihypertensive treatment., J Clin Epidemiol, 61, 282, 10.1016/j.jclinepi.2007.04.007 · DOI
- Krousel-Wood, 2009, New medication adherence scale versus pharmacy fill rates in seniors with hypertension., Am J Manag Care, 15, 59
- Chobanian, 2003, The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report., JAMA, 289, 2560, 10.1001/jama.289.19.2560 · DOI · Paper page
- Sackett, 1975, Randomised clinical trial of strategies for improving medication compliance in primary hypertension., Lancet, 1, 1205, 10.1016/S0140-6736(75)92192-3 · DOI
- Morisky, 2011, Improving the measurement of self-reported medication nonadherence: final response., J Clin Epidemiol, 64, 262, 10.1016/j.jclinepi.2010.09.010 · DOI
- Jaeschke, 1994, Users guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients The Evidence-Based Medicine Working Group., JAMA, 271, 703, 10.1001/jama.1994.03510330081039 · DOI
- Kronish, 2011, Meta-analysis: impact of drug class on adherence to antihypertensives., Circulation, 123, 1611, 10.1161/CIRCULATIONAHA.110.983874 · DOI
- Jung, 2013, Resistant hypertension Assessment of adherence by toxicological urine analysis., J Hypertens, 31, 766, 10.1097/HJH.0b013e32835e2286 · DOI · Paper page
- Christensen, 2009, Electronic monitoring of patient adherence to oral antihypertensive medical treatment: a systematic review., J Hypertens, 27, 1540, 10.1097/HJH.0b013e32832d50ef · DOI
- Heisler, 2012, Improving blood pressure control through a clinical pharmacist outreach program in patients with diabetes mellitus in 2 high-performing health systems: the adherence and intensification of medications cluster randomized, controlled pragmatic trial., Circulation, 125, 2863, 10.1161/CIRCULATIONAHA.111.089169 · DOI
- Schectman, 2004, Can prescription refill feedback to physicians improve patient adherence Am J Med S, ci, 327, 19
- Ceral, 2011, Difficult-to-control arterial hypertension or uncooperative patients The assessment of serum antihypertensive drug levels to differentiate nonresponsiveness from nonadherence to recommended therapy., Hypertension Res, 34, 87, 10.1038/hr.2010.183 · DOI
- Strauch, 2013, Precise assessment of noncompliance with the antihypertensive therapy in patients with resistant hypertension using toxicological serum analysis., J Hypertens, 31, 2455, 10.1097/HJH.0b013e3283652c61 · DOI
- Brinker, 2014, Therapeutic drug monitoring facilitates blood pressure control in resistant hypertension., J Am Coll Cardiol, 63, 834, 10.1016/j.jacc.2013.10.067 · DOI
- Tomaszewski, 2014, High rates of nonadherence to antihypertensive treatment revealed by high-performance liquid chromatography-tandem mass spectrometry (HP LC-MSMS) urine analysis., Heart, 100, 855, 10.1136/heartjnl-2013-305063 · DOI · Paper page
Cited by
Sorted by citations
Adherence is associated with a favorable outcome after lung transplantation
Bertram, A., Fuge, J., Suhling, H., Tudorache, I., Haverich, A., Welte, T., & Gottlieb, J. (2019) · PLoS ONE · doi:10.1371/journal.pone.0226167 · Cited by 34
“Patients tend to overestimate their adherence in self-reports with a self-reported adherence rate of 75–90%, while electronic measurements indicated adherence in less than 60% of patients[30].”
Background
Metadata
- Authors
- Gallagher, B. D., Muntner, P., Moise, N., Lin, J. J., & Kronish, I. M.
- Affiliations
- Columbia University Irving Medical Center (US)
- University of Alabama at Birmingham (US)
- Icahn School of Medicine at Mount Sinai (US)
- Corresponding author
- Kronish, Ian M.
- Venue
- Journal of Hypertension
- Published
- 2015-05
- Volume
- 33
- Issue
- 5
- Pages
- 1108-1113
- ISSN
- 0263-6352 (ISSN-L)
- PMC
- PMC4500106
- OpenAlex
- W2078629068
- Cited by
- 50
- References
- 4
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 8 · 2021: 5 · 2020: 5 · 2019: 7 · 2018: 8 · 2017: 5 · 2016: 5
- FWCI
- 7.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- National Institutes of Health (UL1TR000040, 5k07ca166462-05, KL2TR001874)
- National Heart, Lung, and Blood Institute (P01HL047540, K23HL098359, T35HL007616)
- National Cancer Institute (K07 CA-166462)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Health Professions › Pharmacy › Pharmacy and Medical Practices
- Keywords
- medication non-adherence, antihypertensive drugs, self-report questionnaire, Morisky Medication Adherence Scale, visual analogue scale, uncontrolled hypertension, diagnostic validity, likelihood ratios, adherence measurement
- MeSH terms
- Aged, Antihypertensive Agents, Female, Humans, Hypertension, Male, Middle Aged, Surveys and Questionnaires, Medication Adherence, Self Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
