Assessing adherence to medications: Is there a difference between a subjective method and an objective method, or between using them concurrently?

IF 2.4 Q3 PHARMACOLOGY & PHARMACY Pharmacy Practice-Granada Pub Date : 2022-10-01 Epub Date: 2022-10-06 DOI:10.18549/PharmPract.2022.4.2723

Razan I Nassar, Bandana Saini, Nathir M Obeidat, Noor Atatreh, Iman Basheti

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引用次数: 1

Abstract

Background: Patients' adherence to medication can be assessed by several subjective or objective methods. The Global Initiative for Asthma (GINA) has recommended the use of both measures simultaneously.

Objective: To assess patients' adherence to medication using a subjective or an objective method separately, and via using a combination of both methods. As well as identifying the degree of agreement between the two methods.

Methods: Participants who met the study inclusion criteria completed the Adherence to Asthma Medication Questionnaire (AAMQ). A retrospective audit was conducted in order to extract pharmacy refill records for the previous twelve months. The patients' pharmacy refill records were expressed using the Medication Possession Ratio (MPR). Data were analyzed using the Statistical Package for Social Science. The degree of agreement was determined by Cohen's kappa coefficient (κ).

Results: In terms of the difference in the ability of each method to identify non-adherent patients, a higher percentage of non-adherent patients were identified using the self-reported AAMQ (61.4%) compared to the pharmacy refill records (34.3%). When both methods, in combination, were used to assess adherence, the percentage of non-adherent patients was 80.0%, which is higher than each method when used separately. Twenty percent of the patients were considered adherent on both assessment methods, while 15.7% were considered non-adherent via both methods. Consequently, the AAMQ and pharmacy refill records agreed on 35.7% of the patients. The degree of agreement analysis showed a low correlation between the two methods.

Conclusion: The combination strategy resulted in a higher percentage of non-adherent patients, compared to using a subjective (the AAMQ) or an objective (the pharmacy refill records) method. The GINA guideline proposition may be supported by the present study's findings.

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评估药物依从性：主观方法和客观方法之间，或者同时使用它们之间有区别吗？

背景：患者对药物的依从性可以通过几种主观或客观的方法来评估。全球哮喘倡议（GINA）建议同时使用这两种措施。目的：分别使用主观或客观方法，并通过两种方法的结合来评估患者对药物的依从性。以及确定两种方法之间的一致程度。方法：符合研究纳入标准的参与者完成哮喘药物依从性问卷（AAMQ）。进行了一次回顾性审计，以提取前12个月的药房补充记录。患者的药房补充记录使用药物占有率（MPR）表示。使用社会科学统计软件包对数据进行分析。一致程度由Cohen的kappa系数（κ）决定。结果：就每种方法识别非粘附患者的能力差异而言，与药房补充记录（34.3%）相比，使用自我报告的AAMQ识别非粘附性患者的百分比更高（61.4%）。当两种方法结合使用来评估粘附性时，非粘附性病患的百分比为80.0%，其在单独使用时高于每种方法。20%的患者在两种评估方法中都被认为是粘附性的，而15.7%的患者在这两种方法中都认为是非粘附性的。因此，AAMQ和药房补充记录对35.7%的患者达成一致。一致性分析表明，这两种方法之间的相关性很低。结论：与使用主观（AAMQ）或客观（药房补充记录）方法相比，联合策略导致了更高比例的非依从性患者。GINA指南的主张可能得到本研究结果的支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacy Practice-Granada PHARMACOLOGY & PHARMACY-

CiteScore

3.90

自引率

4.00%

发文量

113

审稿时长

20 weeks

期刊介绍： Pharmacy Practice is a free full-text peer-reviewed journal with a scope on pharmacy practice. Pharmacy Practice is published quarterly. Pharmacy Practice does not charge and will never charge any publication fee or article processing charge (APC) to the authors. The current and future absence of any article processing charges (APCs) is signed in the MoU with the Center for Pharmacy Practice Innovation (CPPI) at Virginia Commonwealth University (VCU) School of Pharmacy. Pharmacy Practice is the consequence of the efforts of a number of colleagues from different Universities who belief in collaborative publishing: no one pays, no one receives. Although focusing on the practice of pharmacy, Pharmacy Practice covers a wide range of pharmacy activities, among them and not being comprehensive, clinical pharmacy, pharmaceutical care, social pharmacy, pharmacy education, process and outcome research, health promotion and education, health informatics, pharmacoepidemiology, etc.