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Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties

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Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties. / Koschack, Janka; Marx, Gabriella; Schnakenberg, Jörg; Kochen, Michael M; Himmel, Wolfgang.

In: J CLIN EPIDEMIOL, Vol. 63, No. 3, 03.2010, p. 299-306.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Koschack, J, Marx, G, Schnakenberg, J, Kochen, MM & Himmel, W 2010, 'Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties', J CLIN EPIDEMIOL, vol. 63, no. 3, pp. 299-306. https://doi.org/10.1016/j.jclinepi.2009.06.011

APA

Koschack, J., Marx, G., Schnakenberg, J., Kochen, M. M., & Himmel, W. (2010). Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties. J CLIN EPIDEMIOL, 63(3), 299-306. https://doi.org/10.1016/j.jclinepi.2009.06.011

Vancouver

Koschack J, Marx G, Schnakenberg J, Kochen MM, Himmel W. Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties. J CLIN EPIDEMIOL. 2010 Mar;63(3):299-306. https://doi.org/10.1016/j.jclinepi.2009.06.011

Bibtex

@article{4c8efc136ba14b2d9c15bb20e38e84aa,
title = "Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties",
abstract = "OBJECTIVE: In cases of insufficiently controlled blood pressure, it is important for practitioners to distinguish between {"}nonadherence{"} and {"}nonresponse{"} to antihypertensive drug treatment. A reliable and valid adherence measurement based on the patient's self-report may be helpful in daily practice.STUDY DESIGN AND SETTING: In a primary care sample with 353 hypertensive patients, we applied two self-rating instruments to assess medication adherence (the {"}Hill-Bone Compliance to High Blood Pressure Therapy Scale{"} and Morisky's {"}Self-Reported Measure of Medication Adherence{"}) and compared their psychometric properties.RESULTS: Both scales showed low acceptability and insufficiency to moderate internal consistency (Cronbach's alpha=0.25 and 0.73, respectively). Their convergent validity as indexed by kappa=0.39 could be judged as {"}fair{"} at best. Testing the power to predict blood pressure >140/90mmHg, both scales showed an accuracy of 57% and 62%, respectively. The positive likelihood, that is, the increase in likelihood of high blood pressure in cases of nonadherence was 1.00 and 1.32, respectively.CONCLUSION: The use of both scales cannot be recommended. They showed considerable floor effects, and their ability to identify medication adherence was inconsistent for nearly every third patient. The power of both scales to predict uncontrolled blood pressure was essentially a chance. The underlying conceptual framework of medication adherence therefore needs to be rethought.",
keywords = "Aged, Antihypertensive Agents/administration & dosage, Female, Humans, Hypertension/drug therapy, Male, Medication Adherence/statistics & numerical data, Middle Aged, Psychometrics, Reproducibility of Results, Self Administration/standards, Self Disclosure, Surveys and Questionnaires",
author = "Janka Koschack and Gabriella Marx and J{\"o}rg Schnakenberg and Kochen, {Michael M} and Wolfgang Himmel",
year = "2010",
month = mar,
doi = "10.1016/j.jclinepi.2009.06.011",
language = "English",
volume = "63",
pages = "299--306",
journal = "J CLIN EPIDEMIOL",
issn = "0895-4356",
publisher = "Elsevier USA",
number = "3",

}

RIS

TY - JOUR

T1 - Comparison of two self-rating instruments for medication adherence assessment in hypertension revealed insufficient psychometric properties

AU - Koschack, Janka

AU - Marx, Gabriella

AU - Schnakenberg, Jörg

AU - Kochen, Michael M

AU - Himmel, Wolfgang

PY - 2010/3

Y1 - 2010/3

N2 - OBJECTIVE: In cases of insufficiently controlled blood pressure, it is important for practitioners to distinguish between "nonadherence" and "nonresponse" to antihypertensive drug treatment. A reliable and valid adherence measurement based on the patient's self-report may be helpful in daily practice.STUDY DESIGN AND SETTING: In a primary care sample with 353 hypertensive patients, we applied two self-rating instruments to assess medication adherence (the "Hill-Bone Compliance to High Blood Pressure Therapy Scale" and Morisky's "Self-Reported Measure of Medication Adherence") and compared their psychometric properties.RESULTS: Both scales showed low acceptability and insufficiency to moderate internal consistency (Cronbach's alpha=0.25 and 0.73, respectively). Their convergent validity as indexed by kappa=0.39 could be judged as "fair" at best. Testing the power to predict blood pressure >140/90mmHg, both scales showed an accuracy of 57% and 62%, respectively. The positive likelihood, that is, the increase in likelihood of high blood pressure in cases of nonadherence was 1.00 and 1.32, respectively.CONCLUSION: The use of both scales cannot be recommended. They showed considerable floor effects, and their ability to identify medication adherence was inconsistent for nearly every third patient. The power of both scales to predict uncontrolled blood pressure was essentially a chance. The underlying conceptual framework of medication adherence therefore needs to be rethought.

AB - OBJECTIVE: In cases of insufficiently controlled blood pressure, it is important for practitioners to distinguish between "nonadherence" and "nonresponse" to antihypertensive drug treatment. A reliable and valid adherence measurement based on the patient's self-report may be helpful in daily practice.STUDY DESIGN AND SETTING: In a primary care sample with 353 hypertensive patients, we applied two self-rating instruments to assess medication adherence (the "Hill-Bone Compliance to High Blood Pressure Therapy Scale" and Morisky's "Self-Reported Measure of Medication Adherence") and compared their psychometric properties.RESULTS: Both scales showed low acceptability and insufficiency to moderate internal consistency (Cronbach's alpha=0.25 and 0.73, respectively). Their convergent validity as indexed by kappa=0.39 could be judged as "fair" at best. Testing the power to predict blood pressure >140/90mmHg, both scales showed an accuracy of 57% and 62%, respectively. The positive likelihood, that is, the increase in likelihood of high blood pressure in cases of nonadherence was 1.00 and 1.32, respectively.CONCLUSION: The use of both scales cannot be recommended. They showed considerable floor effects, and their ability to identify medication adherence was inconsistent for nearly every third patient. The power of both scales to predict uncontrolled blood pressure was essentially a chance. The underlying conceptual framework of medication adherence therefore needs to be rethought.

KW - Aged

KW - Antihypertensive Agents/administration & dosage

KW - Female

KW - Humans

KW - Hypertension/drug therapy

KW - Male

KW - Medication Adherence/statistics & numerical data

KW - Middle Aged

KW - Psychometrics

KW - Reproducibility of Results

KW - Self Administration/standards

KW - Self Disclosure

KW - Surveys and Questionnaires

U2 - 10.1016/j.jclinepi.2009.06.011

DO - 10.1016/j.jclinepi.2009.06.011

M3 - SCORING: Journal article

C2 - 19762213

VL - 63

SP - 299

EP - 306

JO - J CLIN EPIDEMIOL

JF - J CLIN EPIDEMIOL

SN - 0895-4356

IS - 3

ER -