Validation of self-reported adherence in chronic patients visiting pharmacies and factors associated with the overestima
- PDF / 296,971 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 66 Downloads / 160 Views
PHARMACOEPIDEMIOLOGY AND PRESCRIPTION
Validation of self-reported adherence in chronic patients visiting pharmacies and factors associated with the overestimation and underestimation of good adherence C. Valdés y Llorca 1,2 & Ernesto Cortés-Castell 1,2,3 & J. M. Ribera-Casado 1,2 & P. de Lucas-Ramos 1,2 & L. M. de Palacio-Guerrero 2 & F. Mugarza-Borqué 2 & J. L. Casteig-Ayestarán 1,4 & J. Díaz-Olmo 1,4 & A. Casteig-Blanco 1,4 & V. F. Gil-Guillén 1,2,5 & M. Rizo-Baeza 1,6 Received: 4 March 2020 / Accepted: 29 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Studies validating indirect methods to identify nonadherence in chronic patients who visit pharmacies are lacking. The aim of this study was to validate self-reported adherence and assess the variables associated with both overestimation and underestimation of good adherence when using this method. Materials and methods An observational, cross-sectional study was undertaken to validate self-reported adherence in 132 community pharmacies throughout Spain in 6237 chronic patients. The Morisky-Green test was used as the validation method and through a 2 × 2 table, the validity indicators, predictive values, and likelihood ratios were calculated. To assess the variables associated with both overestimation and underestimation of good adherence, multivariate logistic regression analysis and calculation of the area under the ROC curve were used to evaluate discriminatory capacity. Results Sensitivity was 27.8% (95% CI: 26.2–29.4) and specificity was 93.9% (95% CI: 93.1–94.7). Discrepancy analysis obtained a significant overestimation of good adherence (p < 0.001). The factors associated with overestimating good adherence were performing a mnemonic trick (p < 0.001), not self-medicating (p < 0.001), a high level of physical activity (p < 0.001), and an older age (p = 0.014). Factors associated with underestimation were self-medication (p < 0.001), desiring more information (p < 0.001), smoking (p = 0.014), not engaging in physical activity in the low (p = 0.006) or high (p < 0.001) categories, having a younger mean age (p = 0.007), and taking two to three (p = 0.029) or four or more (p < 0.001) chronic treatments. Conclusion Self-reported adherence has good specificity but poor sensitivity. The associated profiles of the discrepancies were obtained to identify both good and poor adherence. Keywords Pharmacological non-adherence . Adherence . Treatment . Chronic diseases . Pharmacies
C. Valdés y Llorca, J. M. Ribera-Casado, P. de Lucas-Ramos, L. M. de Palacio-Guerrero, F. Mugarza-Borqué and V. F. Gil-Guillén contributed equally to this work. * Ernesto Cortés-Castell [email protected] 1
Chair Adherence to Treatment, Miguel Hernández University, San Juan de Alicante, Alicante, Spain
2
Scientific Committee Observatory Group Adherence to Treatment, Madrid, Spain
3
Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University, Ctra Valencia-Alicante S/N, 03550 San Juan de Alicante, Alicante, Spai
Data Loading...
