1
|
Panichaporn S, Chanapai W, Srisomnuek A, Thaweeratthakul P, Katchamart W. Validity and Reliability of the Thai Version of the 19-Item Compliance-Questionnaire-Rheumatology. Patient Prefer Adherence 2022; 16:2149-2158. [PMID: 36003800 PMCID: PMC9393110 DOI: 10.2147/ppa.s374445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/11/2022] [Indexed: 01/13/2023] Open
Abstract
PURPOSE To evaluate the psychometric properties and feasibility of the Thai version of Compliance-Questionnaire-Rheumatology (CQR)-19. PATIENTS AND METHODS A cross-sectional study was conducted in the Rheumatology clinic of Siriraj hospital from October 2020 to March 2022. Literate patients diagnosed with rheumatoid arthritis and aged ≥ 18 years old were included. Participants completed the Thai CQR-19 at baseline and during a follow-up visit. A pill count at the follow-up visit indicating that ≤ 80% of prescribed pills were taken was defined as poor compliance. Feasibility was assessed by the time to completion and the number of missing questions. RESULTS 156 participants were enrolled and 88% were in good compliance. The sensitivity of the CQR-19 to detect good compliance was 78.2% and the specificity was 27.8%. The Thai CQR-19 showed moderate agreement (Gwet's AC1= 0.61, p < 0.01) with 72.2% agreement against pill counts. The Thai CQR-19 had good internal consistency (Cronbach's alpha = 0.83) with moderate test-retest reliability (intraclass coefficients = 0.64, 95% CI 0.54-0.73; p < 0.05). There was a weak correlation between the Thai CQR-19 and disease activity (rs = 0.20, p < 0.05), and no correlation with functional disability (rs = 0.09, p = 0.25). The median (IQR) completion time was 4.42 (3.25-6.16) minutes and 114 (73%) completed all 19 questions. CONCLUSION The Thai version of CQR-19 is a valid and reliable tool to assess medication compliance in Thai patients with RA. To ensure completeness and accuracy, this questionnaire may be administered by interview.
Collapse
Affiliation(s)
- Saranya Panichaporn
- Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wanwisa Chanapai
- Division of Clinical Trials, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ananya Srisomnuek
- Division of Clinical Trials, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phakhamon Thaweeratthakul
- Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wanruchada Katchamart
- Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Correspondence: Wanruchada Katchamart, Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok, 10700, Thailand, Tel +66 2 419 7775, Fax +66 2 418 3222, Email
| |
Collapse
|
2
|
Balsa A, García de Yébenes MJ, Carmona L. Multilevel factors predict medication adherence in rheumatoid arthritis: a 6-month cohort study. Ann Rheum Dis 2021; 81:327-334. [PMID: 34844924 DOI: 10.1136/annrheumdis-2021-221163] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/03/2021] [Indexed: 01/20/2023]
Abstract
Non-adherence challenges efficacy and costs of healthcare. Knowledge of the underlying factors is essential to design effective intervention strategies. OBJECTIVES To estimate the prevalence of treatment adherence in rheumatoid arthritis (RA) and to evaluate its predictors. METHODS A 6-month prospective cohort study of patients with RA selected by systematic stratified sampling (33% on first disease-modifying rheumatic drug (DMARD), 33% on second-line DMARD and 33% on biologics). The outcome measure was treatment adherence, defined by a score greater than 80% both in the Compliance Questionnaire in Rheumatology and the Reported Adherence to Medication scale, and was estimated with 95% CIs. Predictive factors included sociodemographic, psychological, clinical, drug-related, patient-doctor relationship related and logistic. Their effect on 6-month adherence was examined by multilevel logistic models adjusted for baseline covariates. RESULTS 180 patients were recruited (77% women, mean age 60.8). The prevalence of adherence was 59.1% (95% CI 48.1% to 71.8%). Patients on biologics showed higher adherence and perceived a higher medication need than the others; patients on second-line DMARDs had experienced more adverse events than the others. The variables explaining adherence in the final multivariate model were the type of treatment prescribed (second-line DMARDs OR=5.22, and biologics OR=3.76), agreement on treatment (OR=4.57), having received information on treatment adaptation (OR=1.42) and the physician perception of patient trust (OR=1.58). These effects were independent of disease activity. CONCLUSION Treatment adherence in RA is far from complete. Psychological, communicational and logistic factors influence treatment adherence in RA to a greater extent than sociodemographic or clinical factors.
Collapse
|
3
|
Merino-Soto C, Angulo-Ramos M. Metric studies of the compliance questionnaire on rheumatology (CQR): A case of validity induction? REUMATOLOGIA CLINICA 2021; 18:497-498. [PMID: 34531170 DOI: 10.1016/j.reumae.2021.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/19/2021] [Indexed: 10/20/2022]
|
4
|
Merino-Soto C, Angulo-Ramos M. Metric Studies of the Compliance Questionnaire on Rheumatology (CQR): A Case of Validity Induction? REUMATOLOGIA CLINICA 2021; 18:S1699-258X(21)00093-0. [PMID: 33931337 DOI: 10.1016/j.reuma.2021.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 03/19/2021] [Indexed: 11/26/2022]
|
5
|
Mendoza-Pinto C, García-Carrasco M, Campos-Rivera S, Munguía-Realpozo P, Etchegaray-Morales I, Ayón-Aguilar J, Alonso-García NE, Méndez-Martínez S. Medication adherence is influenced by resilience in patients with systemic lupus erythematosus. Lupus 2021; 30:1051-1057. [PMID: 33794703 DOI: 10.1177/09612033211004722] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Evidence on the relationship between resilience and medication adherence in systemic lupus erythematosus (SLE) patients is lacking. We aimed to examine the impact of resilience on medication adherence in SLE patients. METHOD In a cross-sectional analysis SLE outpatients were assessed for resilience (Connor-Davison Resilience Scale, CD-RISC), depressive symptoms (CES-D) and medication adherence (Compliance Questionnaire for Rheumatology [CQR]). The disease activity index (mexSLEDAI) and damage (SLICC Damage Index) were administered. Factors independently associated with adherence were identified using multivariate logistic regression. RESULTS Of the 157 patients, 152 (96.8%) were female with a median age of 45.9 (IQR: 39.0-55.5) years and disease duration of 14 (IQR: 10.0-19.0) years. Medication adherence (CQR ≥80%) and depressive symptoms were found in 74.5% and 43.9% of patients, respectively. Adherent patients had a lower CES-D score and a higher CD-RISC score. In the multivariate analysis adjusting for demographic and clinical confounders, resilience and older age protected against non-adherence (OR 0.96, [95% CI 0.94-0.99] and OR 0.96 [95% CI 0.93-0.98], respectively). CONCLUSION In SLE patients, resilience and older age, which possibly associated with better medication adherence, may protect against non-adherence.
Collapse
Affiliation(s)
- Claudia Mendoza-Pinto
- Systemic Autoimmune Diseases Research Unit, High-Specialty Medical Unit-CIBIOR, Mexican Social Security Institute, Puebla, México.,Department of Rheumatology and Immunology, Medicine School, Meritorious Autonomous University of Puebla, Puebla, Mexico
| | - Mario García-Carrasco
- Systemic Autoimmune Diseases Research Unit, High-Specialty Medical Unit-CIBIOR, Mexican Social Security Institute, Puebla, México.,Department of Rheumatology and Immunology, Medicine School, Meritorious Autonomous University of Puebla, Puebla, Mexico
| | - Sandra Campos-Rivera
- Department of Rheumatology and Immunology, Medicine School, Meritorious Autonomous University of Puebla, Puebla, Mexico
| | - Pamela Munguía-Realpozo
- Systemic Autoimmune Diseases Research Unit, High-Specialty Medical Unit-CIBIOR, Mexican Social Security Institute, Puebla, México.,Department of Rheumatology and Immunology, Medicine School, Meritorious Autonomous University of Puebla, Puebla, Mexico
| | - Ivet Etchegaray-Morales
- Department of Rheumatology and Immunology, Medicine School, Meritorious Autonomous University of Puebla, Puebla, Mexico
| | - Jorge Ayón-Aguilar
- Research Coordination, Puebla Delegation, Mexican Social Security Institute, Puebla, México
| | - Norma Edith Alonso-García
- Department of Psychology, Medicine School, Meritorious Autonomous University of Puebla, Puebla, Mexico
| | | |
Collapse
|
6
|
Aljohani R, Aljohani Z, Aljohani R, Alsaidalani R. Saudi cultural adaptation of the "compliance questionnaire of Rheumatology" for Rheumatoid arthritis patients on disease modifying anti-rheumatic drugs (DMARDs). Saudi Pharm J 2021; 29:377-383. [PMID: 34135664 PMCID: PMC8180466 DOI: 10.1016/j.jsps.2021.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/06/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose This study aims to develop a valid and reliable Arabic version of the Compliance Questionnaire on Rheumatology (CQR-A) and to explore the impact of demographic factors on compliance. Methods This is a descriptive cross-sectional study carried out at the outpatient clinics of rheumatology in King Fahad hospital (KFH) in Madinah, Saudi Arabia, from May 2019 to October 2019. Initially, the original version was culturally adapted to an Arabic version by forward translation, backward translation, committee review of both the Arabic and the original versions, and lastly, pre-testing. Then, seventy-two rheumatoid arthritis patients were recruited to evaluate the reliability and validity of the CQR-A. Reliability was assessed by the test–retest method with a two-week interval through the intraclass correlation coefficient (ICC). The criterion validity of the CQR-A was assessed through Pearson correlation of pharmacy refill and CQR-A. The content validity index (CVI) was used to determine content validity. Multiple regression analysis was done to evaluate the effect of demographic factors on compliance. Results The CQR-A has adequate reliability and validity. The ICC = 0.757 with a 95% CI ranging from 0.579 to 0.860, p < 0.001, Cronbach’s alpha coefficient = 0.788. Pearson correlation coefficient was found to be (r = 0.338, p = 0.013). The individual content validity index (I-CVI) ranged from 0.67 to 1.00, and the average scale content validity index (S-CVI/Ave) = 0.91. Education was the only significant predictor of compliance amongst the demographic factors with R2 of 0.158. Conclusion The Arabic version of the Compliance Questionnaire on Rheumatology (CQR-A) is a reliable and valid clinical tool to assess compliance in Arabic speaking patients.
Collapse
Affiliation(s)
- Roaa Aljohani
- Department of medicine, College of Medicine, Taibah University, Madinah, Saudi Arabia
| | - Zeyad Aljohani
- Department of rheumatology, King Fahad hospital, Madinah, Saudi Arabia
| | - Rawan Aljohani
- College of medicine, Taibah University, Madinah, Saudi Arabia
| | - Raghad Alsaidalani
- College of medicine, Taibah University, Madinah, Saudi Arabia
- Corresponding author at: P.O. Box Address: 7985 Ad Dahhak Ibn Uthman Unit No.1, Al Madinah Al Munawwarah 42364-2945, Saudi Arabia.
| |
Collapse
|
7
|
Omair MA, Al Suwayeh F, Almashaan A, Alqurtas E, Bedaiwi MK, Almaghlouth I, Alkahalaf A, Almalaq HM. Cross-Cultural Validation of the 5-Item Compliance Questionnaire for Rheumatology to the Arabic Language in Patients with Rheumatoid Arthritis. Patient Prefer Adherence 2021; 15:1461-1467. [PMID: 34234419 PMCID: PMC8253897 DOI: 10.2147/ppa.s316263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE A simple measure to assess drug adherence in Saudi patients with rheumatoid arthritis (RA) is required. The aim of this study was to translate and validate the 5-Item Compliance Questionnaire for Rheumatology (CQR5) into Arabic. PATIENTS AND METHODS The questionnaire was translated and culturally adapted to Arab patients in six steps: initial translation, synthesis of the translation, back translation, expert committee review, test of the pre-final version, and development of the Arabic CQR5 (ACQR-5). The resulting version was tested for validity in patients with RA. RESULTS A total of 103 adult patients with RA were recruited from rheumatology clinics at a university hospital in Riyadh, Saudi Arabia. After extensive translation, the final tool (CQR) was piloted in 15 patients. The final validation was performed with 88 patients. Of these, 80 (90.9%) were female and 43.2% were seropositive. The mean (±SD) age and disease duration were 50 (±13) and 11.4 (±8.2) years, respectively. Cronbach's alpha reliability was 0.886, and the Kaiser-Meyer-Olkin measure of sampling adequacy for factor analysis was 0.870 (p<0.001). The mean ACQR-5 was 17.78 (2.70), with 14 (15.9%) classified as low adherents and the remaining 74 (84.1%) as high adherents. Binary logistic regression revealed that increasing age (odds ratio [OR] 1.082, 95% confidence interval [CI]: 1.025-1.142, p=0.005) and a trend toward the presence of other comorbidities (OR 3.111, 95% CI: 0.961-10.070, p=0.058) were associated with low adherence. CONCLUSION ACQR-5 is a simple and feasible tool for identifying adherence levels in patients with RA in Saudi Arabia. A high level of adherence was observed in this study. Additional studies are required to assess ACQR-5 validity and adherence levels in a larger, more diverse population.
Collapse
Affiliation(s)
- Mohammed A Omair
- Rheumatology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
- Correspondence: Mohammed A Omair Rheumatology Division, Department of Medicine (38), College of Medicine King Saud University, PO Box 2925, Riyadh, 11461, Saudi ArabiaTel/Fax +966-1-467-1546 Email
| | - Fatima Al Suwayeh
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Alanoud Almashaan
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Eman Alqurtas
- Rheumatology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed K Bedaiwi
- Rheumatology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ibrahim Almaghlouth
- Rheumatology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz Alkahalaf
- Rheumatology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Haya M Almalaq
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
8
|
Pombo-Suarez M, Maneiro Fernandez JR, Gomez-Reino JJ. Adherence to Treatment in Patients with Rheumatoid Arthritis from Spain. Patient Prefer Adherence 2021; 15:111-117. [PMID: 33531797 PMCID: PMC7847379 DOI: 10.2147/ppa.s291983] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/12/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To evaluate adherence to treatment in a cohort of patients with rheumatoid arthritis in Spain and to identify potential predictors of adherence. METHODS An observational, cross-sectional, multicenter study in outpatient clinics of Rheumatology Departments from 41 centers was conducted. A validated Spanish version of the compliance questionnaire in Rheumatology was used to measure adherence in a cohort of patients with rheumatoid arthritis, representative of the Spanish population. Univariate and multivariate analyses were performed to detect predictors of adherence. RESULTS A total of 859 patients were recruited. An adherence rate of 79% was established. No differences were detected in adherence in patients receiving biologic disease-modifying antirheumatic drugs compared to conventional disease-modifying antirheumatic drugs, in patients receiving intravenous therapies compared to other routes of administration and in patients treated in specific day hospitals compared to polyvalent day hospitals. The number of drugs and cohabitation were independent predictors of adherence. CONCLUSION An inexpensive and useful method was used to measure adherence in Spanish population. The adherence rate in rheumatoid arthritis is still suboptimal. Simpler, more convenient dosing regimens may improve compliance. Increased knowledge of compliance in patients with rheumatoid arthritis and the identification of possible predictors of adherence will allow to develop effective intervention strategies.
Collapse
Affiliation(s)
- Manuel Pombo-Suarez
- Rheumatology Service, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
- Correspondence: Manuel Pombo-Suarez Email
| | | | - Juan Jesus Gomez-Reino
- Fundación Ramón Domínguez, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
| |
Collapse
|