Assessing the Validity of Self-Reported Medication Adherence in Hepatitis C Treatment
Abstract
Objective: To assess the validity of self-reported medication adherence provided by individuals in treatment for hepatitis C virus (HCV) infection with a regimen of peginterferon and ribavirin. Methods: Adherence was evaluated prospectively among 196 African American and 205 white subjects enrolled in Virahep-C (Viral Resistance to Antiviral Therapy of Chronic Hepatitis C), a treatment study for genotype 1 HCV infection. Adherence to the prescribed dose was measured by 2 methods: self-report questions administered during multiple clinic visits, using a touch screen computer; and recordings of bottle openings, using an electronic monitor placed inside the cap of prescription containers. Self-reported responses were compared with the electronic monitor data. Nonparametric tests were used to test the association between adherence measures at 4, 12, 24, 36, and 48 weeks of treatment. Results: The estimated proportion of participants who were adherent prior to a given visit ranged from 85% to 97% (ribavirin) and 97% to 100% (peginterferon) by self report and from 69% to 90% (ribavirin) and 64% to 100% (peginterferon) by electronic monitors. For ribavirin, the percentage of cases in which the 2 measurement methods agreed varied from 68% to 90%; peginterferon agreement was from 84% to 100%. Overall, adherence was higher for peginterferon than for ribavirin but decreased over time for both medications. Self-reported adherence was usually higher than that assessed by electronic measures, and the level of discrepancy increased during the course of treatment. Conclusions: Adherence to peginterferon and ribavirin decreased gradually during therapy but remained relatively high. Simple self-reported measures can be used to screen for nonadherence to HCV drug therapy, but should be considered as overestimation of the actual amounts taken.
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The medication-taking behavior questions gave relatively reliable and valid estimates but tended to overstate how often patients took ribavirin and injected pegylated interferon relative to electronic monitoring.
“During the VIRAHEP-C study, these questions demonstrated relatively reliable and valid estimates, although they tended to overestimate medication adherence to ribavirin and injected pegylated interferon when compared with electronic monitoring devices (46).”
From Reliability and validity of a self‐efficacy instrument for hepatitis C antiviral treatment regimens (2012) · cites this paper as [46]
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- Authors
- Smith, S. R., Wahed, A. S., Kelley, S. S., Conjeevaram, H. S., Robuck, P. R., & Fried, M. W.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- University of Pittsburgh (US)
- University of Michigan (US)
- National Institute of Diabetes and Digestive and Kidney Diseases (US)
- Medicine, University of North Carolina
- Venue
- Annals of Pharmacotherapy
- Publisher
- SAGE Publications
- Published
- 2007-07
- Volume
- 41
- Issue
- 7-8
- Pages
- 1116-1123
- ISSN
- 0012-6578 (ISSN-L)
- 1060-0280
- 1542-6270
- OpenAlex
- W2103634980
- Cited by
- 57
- References
- 11
- Citations by year
- 2022: 1 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 6 · 2013: 9 · 2012: 4
- FWCI
- 4.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Keywords
- medication adherence, hepatitis C, pegylated interferon, ribavirin, self-reported adherence, HCV genotype 1, antiviral therapy, African American patients
- MeSH terms
- Antiviral Agents, Drug Therapy, Combination, Humans, Patient Compliance, Prospective Studies, Surveys and Questionnaires, Self Administration, Hepatitis C, Chronic
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