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Oliveira HC, Hayashi D, Carvalho SDL, Barros RDCLD, Neves MLDS, Andrechuk CRS, Alexandre NMC, Ribeiro PAB, Rodrigues RCM. Quality of measurement properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: a systematic review and meta-analysis. Syst Rev 2023; 12:222. [PMID: 37993931 PMCID: PMC10664314 DOI: 10.1186/s13643-023-02340-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/29/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Medication adherence has a major impact on reducing mortality and healthcare costs related to the treatment of cardiovascular diseases and diabetes mellitus. Selecting the best patient-reported outcome measure (PROM) among the many available for this kind of patient is extremely important. This study aims to critically assess, compare and synthesize the quality of the measurement properties of patient-reported outcome measures to assess medication adherence among patients with cardiovascular diseases and/or type 2 diabetes mellitus. METHODS This review followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). The searches were performed in Web of Science, SCOPUS, PubMed, CINAHL, EMBASE, LILACS, PsycINFO, and ProQuest (gray literature). RESULTS A total of 110 records encompassing 27 different PROMs were included in the review. The included records were published between 1986 and 2023, most of which reported studies conducted in the United States and were published in English. None of the PROMs were classified in the category "a", thus being recommended for use due to the quality of its measurement properties. The PROMs that should not be recommended for use (category "c") are the MTA, GMAS, DMAS-7, MALMAS, ARMS-D, and 5-item questionnaire. The remaining PROMs, e.g., MMAS-8, SMAQ, MEDS, MNPS, ARMS-12, MGT, MTA-OA, MTA-Insulin, LMAS-14, MARS-5, A-14, ARMS-10, IADMAS, MAQ, MMAS-5, ProMAS, ARMS-7, 3-item questionnaire, AS, 12-item questionnaire, and Mascard were considered as having the potential to be recommended for use (category "b"). CONCLUSION None of the included PROMs met the criteria for being classified as trusted and recommended for use for patients with cardiovascular diseases and/or type 2 diabetes mellitus. However, 21 PROMs have the potential to be recommended for use, but further studies are needed to ensure their quality based on the COSMIN guideline for systematic reviews of PROMs. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019129109.
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Affiliation(s)
- Henrique Ceretta Oliveira
- CEPSchool of Nursing - University of Campinas (Unicamp), 126 Tessália Vieira de Camargo Street, Campinas, São Paulo, 13083-887, Brazil.
| | - Daisuke Hayashi
- CEPSchool of Nursing - University of Campinas (Unicamp), 126 Tessália Vieira de Camargo Street, Campinas, São Paulo, 13083-887, Brazil
| | - Samantha Dalbosco Lins Carvalho
- CEPSchool of Nursing - University of Campinas (Unicamp), 126 Tessália Vieira de Camargo Street, Campinas, São Paulo, 13083-887, Brazil
| | - Rita de Cássia Lopes de Barros
- CEPSchool of Nursing - University of Campinas (Unicamp), 126 Tessália Vieira de Camargo Street, Campinas, São Paulo, 13083-887, Brazil
| | - Mayza Luzia Dos Santos Neves
- CEPSchool of Nursing - University of Campinas (Unicamp), 126 Tessália Vieira de Camargo Street, Campinas, São Paulo, 13083-887, Brazil
| | - Carla Renata Silva Andrechuk
- CEPSchool of Nursing - University of Campinas (Unicamp), 126 Tessália Vieira de Camargo Street, Campinas, São Paulo, 13083-887, Brazil
| | - Neusa Maria Costa Alexandre
- CEPSchool of Nursing - University of Campinas (Unicamp), 126 Tessália Vieira de Camargo Street, Campinas, São Paulo, 13083-887, Brazil
| | - Paula Aver Bretanha Ribeiro
- Research Centre of the Montreal University Hospital (CRCHUM), 850 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - Roberta Cunha Matheus Rodrigues
- CEPSchool of Nursing - University of Campinas (Unicamp), 126 Tessália Vieira de Camargo Street, Campinas, São Paulo, 13083-887, Brazil
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Maryem A, Younes I, Yassmine M, Morad G, Karima B, Amal K, Noureddine EK, Mohamed I, Mohamed K, Chahboune M. Translation, cultural adaptation and validation of the General Medication Adherence Scale (GMAS) in moroccan patients with type-2 diabetes. BMC Nurs 2023; 22:302. [PMID: 37667249 PMCID: PMC10476372 DOI: 10.1186/s12912-023-01457-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND The objective of the study was to cross-culturally adapt and validate the General Medication Adherence Scale (GMAS) in patients with type-2 diabetes in Morocco. METHODS The study was a cross-sectional study conducted between September 12 and October 12, 2022, and included patients with type-2 diabetes from a primary health care network. To measure the different psychometric parameters of the construct, data analysis was performed using SPSS v20. The study was approved by the Moroccan Association for Research and Ethics. RESULTS A total of 284 patients were included in the study; the results of the different psychometric parameters were largely acceptable. Indeed, the improvement of the goodness-of-fit of the model in relation to the independence model was evaluated by the comparative fit index (CFI), which was higher than 0.95, as well as the normalized fit index (NFI), which expresses the percentage of the general covariance between the variable demonstrated via the tested model when the null model is taken as reference and was also higher than 0.95 in this study. Additionally, the Tucker Louis Index (TLI) or Unstandardized Fit Index, which measures the increase in goodness of fit when moving from the reference model to the model under study, had a value of > 0.95. The correlations between the items were good; indeed, the Kaiser-Meyer-Olkin (KMO) index was > 0.7. The translated tool presents good internal consistency; thus, Cronbach's α had a value of approximately 0.804 (> 0.7). CONCLUSIONS The version of the GMAS tool adapted to the Moroccan context has very acceptable psychometric values. This means that Moroccan researchers and health professionals can use it as an instrument to measure adherence among individuals with type-2 diabetes.
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Affiliation(s)
- Arraji Maryem
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco.
| | - Iderdar Younes
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
| | - Mourajid Yassmine
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
| | - Guennouni Morad
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
- Higher School of Education and Training, Science and Technology Team, Chouaîb Doukkali University of El Jadida, El Jadida, Morocco
| | - Boumendil Karima
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
| | - Korrida Amal
- High Institute of Nursing Professions and Health Techniques (ISPITS), Agadir, Morocco
- Research Laboratory of Innovation in Health Sciences (LARISS), Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - El Khoudri Noureddine
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
| | - Ifleh Mohamed
- Faculty of Medicine and Pharmacy, Laboratory of Hematology, Mohammad V University, Rabat, Morocco
| | - Khalis Mohamed
- Mohammed VI Center of Research and Innovation, Rabat, Morocco
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco
- Higher Institute of Nursing Professions and Technical Health, Rabat, Morocco
- Laboratory of Biostatistics, Clinical, and Epidemiological Research, Faculty of Medicine and Pharmacy, Department of Public Health, Mohamed V University in Rabat, Rabat, Morocco
| | - Mohamed Chahboune
- Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Hassan First University of Settat, Settat, 26000, Morocco
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Praxedes MFDS, da Silva JLP, da Cruz AJA, Viana CC, Barbosa HC, Guimarães NS, Martins MAP. Assessment of the relationship between the level of patient knowledge on warfarin therapy and the quality of oral anticoagulation: A systematic review and meta-analysis. PLoS One 2023; 18:e0289836. [PMID: 37561771 PMCID: PMC10414645 DOI: 10.1371/journal.pone.0289836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/26/2023] [Indexed: 08/12/2023] Open
Abstract
The present study aimed to investigate the relationship between the level of patient knowledge on warfarin therapy and the quality of oral anticoagulation. This is a systematic review and meta-analysis written on the basis of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Searches at MEDLINE, EMBASE, Scopus and LILACS electronic databases were carried out on February 13, 2023, using the descriptors "Patient Medication Knowledge", "Patient Education as Topic", "Health Education", "Patient Education" and Warfarin. The steps of selection, data extraction and quality analysis of articles were performed independently by two reviewers. The analysis was performed considering patient knowledge as a possible modifier of time in therapeutic range (TTR). The meta-analysis included studies that reported the correlation coefficient (Pearson or Spearman) between patient knowledge and TTR. A subgroup analysis was performed according to questionnaires employed to measure patient knowledge. Twelve studies were selected with an overall sample size of 7634 participants and mean age 58.2 (standard deviation (SD)±12,8) years. Eleven (92.0%) cross-sectional studies. The mean TTR was 57.8% (SD±11,3%) and the average level of knowledge was 60.4%. The meta-analysis indicated that patient level of knowledge on warfarin therapy was moderately associated with TTR (rs = 0.435; 95% confidence interval (CI) = 0.163-0.645; I2 = 96%). Subgroup analysis indicated association between knowledge level and TTR in studies employing the OAK test (rs = 0.617; 95% CI = 0.192-0.847; I2 = 97%) and the AKA (rs = 0.269; 95% CI = 0.002 to 0.501; I2 = 94%). However, the subgroup analysis presented no significant difference between them (p = 0.14). The meta-regression showed a non-significant negative effect of age on the correlation (estimate = -0.028, 95% CI = -0.073 to 0.016, p = 0.207). No publication bias was noted (p = 0.881). To our knowledge, this is the first systematic review and meta-analysis gathering evidence about the relationship between the level of patient knowledge on oral anticoagulation with warfarin and TTR. The implementation of structured and patient-centered educational interventions is essential to effectively increase the level of patient knowledge and, thus, to improve the quality and safety of warfarin therapy. Systematic review registration number: PROSPERO CRD42023398030.
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Affiliation(s)
| | | | | | - Catiane Costa Viana
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Maria Auxiliadora Parreiras Martins
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Tegegn HG, Wark S, Tursan d'Espaignet E, Spark MJ. Measurement Properties of Patient-Reported Outcome Measures for Medication Adherence in Cardiovascular Disease: A COSMIN Systematic Review. Clin Drug Investig 2022; 42:879-908. [PMID: 36180813 PMCID: PMC9617955 DOI: 10.1007/s40261-022-01199-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Several medication adherence patient-reported outcome measures (MA-PROMs) are available for use in patients with cardiovascular disease (CVD); however, little evidence is available on the most suitable MA-PROM to measure medication adherence in patients with CVD. The aim of this systematic review is to synthesise the measurement properties of MA-PROMs for patients with CVD and identify the most suitable MA-PROM for use in clinical practice or future research in patients with CVD. METHODS An electronic search of nine databases (PubMed, MEDLINE, CINAHL, ProQuest Health and Medicine, Cochrane Library, PsychInfo, Scopus, Embase, and Web of Science) was conducted to identify studies that have reported on at least one of the measurement properties of MA-PROMs in patients with CVD. The methodological quality of the studies included in the systematic review was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. RESULTS A total of 40 MA-PROMs were identified in the 84 included studies. This review found there is a lack of moderate-to-high quality evidence of sufficient content validity for all MA-PROMs for patients with CVDs. Only eight MA-PROMs were classified in COSMIN recommendation category A. They exhibited sufficient content validity with very low-quality evidence, and moderate-to-high quality evidence for sufficient internal consistency. The 28 MA-PROMs that meet the requirements for COSMIN recommendation category 'B' require further validation studies. Four MA-PROMs including Hill-Bone Compliance Medication Scale (HBMS), the five-item Medication Adherence Report Scale (MARS-5), Maastricht Utrecht Adherence in Hypertension (MUAH), and MUAH-16 have insufficient results with high quality evidence for at least one measurement property and consequently are not recommended for use in patients with CVD. Two MA-PROMs (Adherence to Refills and Medications Scale [ARMS] and ARMS-7) are comprehensive and have moderate to high quality evidence for four sufficient measurement properties. CONCLUSION From the eight MA-PROMs in COSMIN recommendation category A, ARMS and ARMS-7 were selected as the most suitable MA-PROMs for use in patients with CVD. They are the most comprehensive with be best quality evidence to support their use in clinical practice and research.
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Affiliation(s)
- Henok G Tegegn
- School of Rural Medicine, University of New England, Armidale, 2351, Australia
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Stuart Wark
- School of Rural Medicine, University of New England, Armidale, 2351, Australia
| | - Edouard Tursan d'Espaignet
- School of Rural Medicine, University of New England, Armidale, 2351, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, 2300, Australia
| | - M Joy Spark
- School of Rural Medicine, University of New England, Armidale, 2351, Australia.
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Rezaei S, Vaezi F, Afzal G, Naderi N, Mehralian G. Medication Adherence and Health Literacy in Patients with Heart Failure: A Cross-Sectional Survey in Iran. Health Lit Res Pract 2022; 6:e191-e199. [PMID: 35943838 PMCID: PMC9359808 DOI: 10.3928/24748307-20220718-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Heart failure is a costly condition with high morbidity and mortality rates in low- and middle-income countries. Nonadherence to prescribed therapies can lead to severe problems such as poorer health outcomes, higher health care expenditures, increased hospitalizations, and even higher mortality rates in patients with advanced heart disease. Objective: The aim of the present study is to investigate medication adherence and the association between medication adherence and health literacy in Iranian patients with heart failure. Methods: This study was conducted in the heart failure outpatient clinic of Shahid Rajaee Cardiovascular, Medical, and Research Center in Tehran, Iran. Medical records and validated questionnaires were used to collect the necessary information on the survey variables, including sociodemographic characteristics, medication adherence, and health literacy, for a total of 250 patients with heart failure. Stepwise logistic regression analysis was performed to identify the variables that independently and significantly predicted medication nonadherence. Key Results: The results showed that most patients with heart failure had low medication adherence. Some factors, including gender, health literacy, and duration of illness, were associated with adherence. The study results showed a positive association between higher health literacy and better medication adherence. Conclusion: In view of the results, further studies on heart failure are needed to investigate other factors related to medication adherence and health literacy level to achieve better disease management and improve patients' treatment adherence. [HLRP: Health Literacy Research and Practice. 2022;6(3):e191–e199.] Plain Language Summary: This study investigated the relationship between medication adherence and health literacy in Iranian patients with heart failure. The results showed that most patients had inadequate health literacy. Moreover, it showed a significant and positive relationship between health literacy and medication adherence.
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Affiliation(s)
| | | | | | | | - Gholamhossein Mehralian
- Address correspondence to Gholamhossein Mehralian, PhD, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Hashemi Highway, Valiasr Avenue, P.O. Box 14155-6153, Tehran, Iran;
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Chen H, Xu X, Peng J, Ge X, Zhang J, Dong Q, Jiang X, Li P. Warfarin Adherence Among Patients with Atrial Fibrillation in Rural Area of Dongyang, China: A Questionnaire-Based Study. Patient Prefer Adherence 2022; 16:2345-2352. [PMID: 36046498 PMCID: PMC9423105 DOI: 10.2147/ppa.s374808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Adherence to warfarin is associated with improved outcome in patients with atrial fibrillation (AF), but the adherence status of patients in rural areas of China is not known. METHODS A questionnaire-based study evaluating warfarin adherence of rural residents with AF was carried out in Dongyang, China. Potentially eligible patients were screened and contacted by telephone, and their demographic characteristics were collected. Illness perception was assessed using the Brief Illness Perception Questionnaire (BIPQ), and warfarin adherence was assessed using a Chinese-version adherence scale. Univariate and multivariate analyses were conducted to identify factors associated with unsatisfactory adherence. RESULTS A total of 201 patients (male, n=99; mean age, 70.3±8.12 years) were included, among whom 95 (47.3%) patients showed good adherence and 63 (31.3%) poor adherence. Number of co-dispensed drugs (multivariate analysis: odds ratio [OR]=3.64, 95% confidence interval [CI] 1.35-9.81, p=0.011) and BIPQ score (OR=1.25, 95% CI 1.17-1.33, p<0.001) were identified as factors associated with good adherence. CONCLUSION Medical adherence to warfarin needs to improve in rural patients with AF. Efforts that can reduce the number of co-dispensed drugs and increase illness perception may improve warfarin adherence. This study may benefit future management of warfarin administration to rural patients with AF.
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Affiliation(s)
- Huadong Chen
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
- Correspondence: Huadong Chen, Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, 60th Wuning West Road, Dongyang, People’s Republic of China, Email
| | - Xing’e Xu
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Jiren Peng
- Department of Vasculocardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Xuan Ge
- Health Management Center, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Jing’an Zhang
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Qianqian Dong
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Xiunan Jiang
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
| | - Piaopiao Li
- Department of Pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, People’s Republic of China
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Türker M, Sancar M, Demirtunç R, Uçar N, Uzman O, Ay P, Kozan Ö, Okuyan B. Validation of a Knowledge Test in Turkish Patients on Warfarin Therapy at an Ambulatory Anticoagulation Clinic. Turk J Pharm Sci 2021; 18:445-451. [PMID: 34496551 DOI: 10.4274/tjps.galenos.2020.88319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objectives This study aimed to evaluate the validity and reliability of an oral anticoagulation knowledge (OAK) test in Turkish patients on warfarin therapy at an anticoagulant outpatient clinic. Materials and Methods This study was conducted at an ambulatory anticoagulation clinic and included patients older than 18 years who had been using warfarin for at least six months. Patients' demographic and clinical data were collected. Internal consistency was calculated using the Kuder-Richardson 20 (KR-20) coefficient, and the test-retest reliability of the Turkish version of the OAK test was assessed. Results Patients' mean age was 59.83±11.93 (26-90) years (n=240; 133 women). The mean score of the OAK test was 14.19±3.01. The test-retest reliability of the scale (n=30) was moderate for the total score (p<0.001). The KR-20 value, a measure of internal consistency, was 0.671. Patients of a younger age and higher educational level were more likely to have higher levels of anticoagulation knowledge than patients of an older age and lower education level (p<0.05 for both comparisons). Conclusion The Turkish version of the OAK test can be used to determine the patients' knowledge on oral anticoagulation.
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Affiliation(s)
- Meltem Türker
- Marmara University Faculty of Pharmacy, Department of Clinical Pharmacy, Istanbul, Turkey
| | - Mesut Sancar
- Marmara University Faculty of Pharmacy, Department of Clinical Pharmacy, Istanbul, Turkey
| | - Refik Demirtunç
- University of Health Sciences Turkey, Haydarpasa Numune Training and Research Hospital, Clinic of Internal Medicine, Istanbul, Turkey
| | - Nazlıcan Uçar
- Marmara University Faculty of Pharmacy, Department of Clinical Pharmacy, Istanbul, Turkey
| | - Osman Uzman
- Kars Sarıkamış State Hospital, Clinic of Cardiology, Kars, Turkey
| | - Pınar Ay
- Marmara University Faculty of Medicine, Department of Public Health, Istanbul, Turkey
| | - Ömer Kozan
- Baskent University, Istanbul Hospital, Clinic of Cardiology, Istanbul, Turkey
| | - Betul Okuyan
- Marmara University Faculty of Pharmacy, Department of Clinical Pharmacy, Istanbul, Turkey
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Jang I. A Systematic Review on Mobile Health Applications' Education Program for Patients Taking Oral Anticoagulants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178902. [PMID: 34501492 PMCID: PMC8430962 DOI: 10.3390/ijerph18178902] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022]
Abstract
Warfarin is widely used as an oral anticoagulant. However, it is difficult to manage patients due to its narrow therapeutic range and individualized differences. Using controlled trials and real-world observational studies, this systematic review aimed to analyze health education’s impact among patients on warfarin therapy by mobile application. Smartphone and tablet applications have the potential to actively educate patients by providing them with timely information through push notifications. MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane electronic databases were searched using the keywords “anticoagulants,” “warfarin”, “mobile application”, and “smartphone” up to May 2020. Of the 414 articles obtained, 12 articles met the inclusion criteria for this review. The education and self-management programs using the mobile health application had diverse contents. A meta-analysis was not deemed appropriate because of the heterogeneity of populations, interventions, and outcomes. Thus, a narrative synthesis is presented instead. This review demonstrates that educating patients for anticoagulation management through their smartphones or tablets improves their knowledge levels, medication or treatment adherence, satisfaction, and clinical outcomes. Moreover, it has a positive effect on continuing health care. Future research concerning patients taking warfarin should include key self-management outcomes in larger, more rigorously designed studies, allowing for comparisons across studies. This study proposes a continuous application of timely education through smartphone applications to the current medical and nursing practice.
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Affiliation(s)
- Insil Jang
- Department of Nursing, Chung-Ang University, Seoul 06974, Korea
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Vianna MS, da Silva Praxedes MF, de Araújo VE, Ferreira CB, de Sousa WJFN, Viana CC, Martins MAP. Self-report instruments for assessing adherence to warfarin therapy: a systematic review. Eur J Clin Pharmacol 2021; 77:1765-1781. [PMID: 34292359 DOI: 10.1007/s00228-021-03168-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/30/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The assessment of adherence to warfarin therapy is useful in clinical practice due to its wide variability in dose-response and risks of complications. The aim of this study was to investigate validated instruments used to assess adherence to warfarin therapy. METHODS Information was collected from the MEDLINE (PubMed), LILACS, EMBASE, and Cochrane Library databases. Search strategies were applied for each database, with no time limit or language restriction. Inclusion criteria consisted of study participants of ≥ 18 years of age, from both sexes, on chronic anticoagulation with warfarin for any indication and the use of validated instruments to assess adherence to warfarin therapy. Exclusion criteria consisted of duplicate articles, narrative or systematic reviews, and meta-analyses, as well as case reports/series and experimental studies involving animals. Two independent reviewers performed the following steps: evaluation of titles/abstracts, selection of studies after full reading, data extraction, and evaluation of potential bias. Discrepancies were resolved by a third reviewer. RESULTS Overall, 19 articles were selected for this systematic review, including 17 cross-sectional studies, one cohort study, and one quasi-experimental study, published from 2009 to 2019. The validated instruments identified in this review were Morisky Medication Adherence Scale (MMAS), the eight-item Morisky Medication Adherence Scale (MMAS-8), Measurement of Treatment Adherence (MTA), and Brief Medication Questionnaire (BMQ). Only MMAS-8 was tested for reliability, using the internal consistency assessment, with Cronbach's α range 0.56-0.71. CONCLUSIONS This review highlighted a gap in knowledge regarding the scarcity of validated instruments to assess adherence to warfarin therapy. Limitations were found in instruments that comprised the assessment of the isolated use of medication and the lack of analysis of other relevant therapeutic aspects. Future studies are needed to develop and validate more comprehensive instruments in an attempt to assess adherence to warfarin therapy. PROSPERO Registration number CRD42019128324.
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Affiliation(s)
- Mayara Sousa Vianna
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - Marcus Fernando da Silva Praxedes
- Centro de Ciências da Saúde, Universidade Federal Do Recôncavo da Bahia, Av. do Cajueiro, Cajueiro, Santo Antonio de Jesus, BA, Brazil
| | - Vânia Eloisa de Araújo
- Faculdade de Odontologia, Pontifícia Universidade Católica de Minas Gerais, Av: Dom José Gaspar, 500 Coração Eucarístico, Belo Horizonte, MG, 30535-901, Brazil
| | - Carolina Barbosa Ferreira
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - Waleska Jaclyn Freitas Nunes de Sousa
- Faculdade de Medicina da, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Bairro Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil
| | - Catiane Costa Viana
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - Maria Auxiliadora Parreiras Martins
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, 31270-901, Brazil.
- Faculdade de Medicina da, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Bairro Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil.
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Shilbayeh SAR, Ismail SAER. Patient experience with an educational mobile health application: A pilot study on usability and feasibility in a Saudi population. COGENT PSYCHOLOGY 2020. [DOI: 10.1080/23311908.2020.1843883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Sireen Abdul Rahim Shilbayeh
- Computer Science Department, College of Computer and Information Sciences, Princess Nourah Bint Abdulrahman University Riyadh, Saudi Arabia
| | - Sahar Abd El Rahman Ismail
- Department of Computer Science, College of Computer and Information Sciences, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
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Shilbayeh SAR, Ismail SAER. Translation, Pilot Psychometric Validation, and Comparative Performance of the Arabic Version of the Anti-Clot Treatment Scale (ACTS). J Pharm Bioallied Sci 2020; 13:61-68. [PMID: 34084049 PMCID: PMC8142906 DOI: 10.4103/jpbs.jpbs_395_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/07/2020] [Accepted: 08/17/2020] [Indexed: 11/04/2022] Open
Abstract
Background Anticoagulation management is a complex process that is managed through careful monitoring, and patient satisfaction has a significant impact. Given the lack of a valid and reliable tool in Arabic to examine patient satisfaction, the present study aimed to translate and examine some of the psychometric properties of the Anti-Clot Treatment Scale (ACTS) among Saudi patients. Materials and Methods This was a cross-sectional, methodological study conducted among patients receiving warfarin. The questionnaire was subjected to translation by using a multistep method. The final Arabic translated version of the ACTS underwent face and content validity assessments by independent experts to ensure its conceptual equivalence to the original English version. Subsequently, pilot testing of convergent, discriminant, and criterion validities were examined. Results Overall, 136 patients participated in the study. All patients were asked to complete the generic Treatment Satisfaction Questionnaire for Medication (TSQM) alongside the ACTS tool. Convergent validity analyses revealed statistically significant positive correlations (p < 0.01) between the ACTS subscales and the four TSQM subdomains, as reflected by the Spearman correlation coefficient (r). Interestingly, the strongest correlations were observed between ACTS Burdens and the TSQM convenience domain (r = 0.61) and between ACTS Benefits and the TSQM effectiveness satisfaction score (r = 0.58). Similarly, discriminant validity was evidenced by moderate to high significant loading of all 12 items on each of their corresponding ACTS subscales. Conclusion These findings of adequate validity support the use of the ACTS in Saudi patients receiving anticoagulant medications to measure their specific satisfaction levels with this type of therapy. However, future research addressing the clinical impact of ACTS scores in the Saudi population is needed.
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Affiliation(s)
- Sireen Abdul Rahim Shilbayeh
- Department of Pharmaceutical Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University (PNU), Riyadh, Saudi Arabia
| | - Sahar Abd El Rahman Ismail
- Department of Computer Science, College of Computer and Information Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Kwan YH, Weng SD, Loh DHF, Phang JK, Oo LJY, Blalock DV, Chew EH, Yap KZ, Tan CYK, Yoon S, Fong W, Østbye T, Low LL, Bosworth HB, Thumboo J. Measurement Properties of Existing Patient-Reported Outcome Measures on Medication Adherence: Systematic Review. J Med Internet Res 2020; 22:e19179. [PMID: 33034566 PMCID: PMC7584986 DOI: 10.2196/19179] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/05/2020] [Accepted: 08/08/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Medication adherence is essential for improving the health outcomes of patients. Various patient-reported outcome measures (PROMs) have been developed to measure medication adherence in patients. However, no study has summarized the psychometric properties of these PROMs to guide selection for use in clinical practice or research. OBJECTIVE This study aims to evaluate the quality of the PROMs used to measure medication adherence. METHODS This study was guided by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Relevant articles were retrieved from the EMBASE, PubMed, Cochrane Library, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases. The PROMs were then evaluated based on the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. RESULTS A total of 121 unique medication adherence PROMs from 214 studies were identified. Hypotheses testing for construct validity and internal consistency were the most frequently assessed measurement properties. PROMs with at least a moderate level of evidence for ≥5 measurement properties include the Adherence Starts with Knowledge 20, Compliance Questionnaire-Rheumatology, General Medication Adherence Scale, Hill-Bone Scale, Immunosuppressant Therapy Barrier Scale, Medication Adherence Reasons Scale (MAR-Scale) revised, 5-item Medication Adherence Rating Scale (MARS-5), 9-item MARS (MARS-9), 4-item Morisky Medication Adherence Scale (MMAS-4), 8-item MMAS (MMAS-8), Self-efficacy for Appropriate Medication Adherence Scale, Satisfaction with Iron Chelation Therapy, Test of Adherence to Inhalers, and questionnaire by Voils. The MAR-Scale revised, MMAS-4, and MMAS-8 have been administered electronically. CONCLUSIONS This study identified 121 PROMs for medication adherence and provided synthesized evidence for the measurement properties of these PROMs. The findings from this study may assist clinicians and researchers in selecting suitable PROMs to assess medication adherence.
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Affiliation(s)
- Yu Heng Kwan
- Program in Health Services and Systems Research,, Duke-NUS Medical School, Singapore, Singapore
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Si Dun Weng
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Dionne Hui Fang Loh
- PULSES Centre Grant, SingHealth Regional Health System, Singapore, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Livia Jia Yi Oo
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Dan V Blalock
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Eng Hui Chew
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Kai Zhen Yap
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Corrinne Yong Koon Tan
- Pharmacy Transformation Office, National Healthcare Group Pharmacy, Singapore, Singapore
| | - Sungwon Yoon
- Program in Health Services and Systems Research,, Duke-NUS Medical School, Singapore, Singapore
- PULSES Centre Grant, SingHealth Regional Health System, Singapore, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Truls Østbye
- Program in Health Services and Systems Research,, Duke-NUS Medical School, Singapore, Singapore
| | - Lian Leng Low
- PULSES Centre Grant, SingHealth Regional Health System, Singapore, Singapore
- Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, Singapore
- Post Acute and Continuing Care, Outram Community Hospital, Singapore, Singapore
| | - Hayden Barry Bosworth
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
- Department of Population Health Sciences, Duke University Medical Center, Durham, NC, United States
- School of Nursing, Duke University Medical Center, Durham, NC, United States
| | - Julian Thumboo
- Program in Health Services and Systems Research,, Duke-NUS Medical School, Singapore, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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13
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Kwan YH, Oo LJY, Loh DHF, Phang JK, Weng SD, Blalock DV, Chew EH, Yap KZ, Tan CYK, Yoon S, Fong W, Østbye T, Low LL, Bosworth HB, Thumboo J. Development of an Item Bank to Measure Medication Adherence: Systematic Review. J Med Internet Res 2020; 22:e19089. [PMID: 33030441 PMCID: PMC7582150 DOI: 10.2196/19089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/12/2020] [Accepted: 06/14/2020] [Indexed: 02/06/2023] Open
Abstract
Background Medication adherence is important in managing the progression of chronic diseases. A promising approach to reduce cognitive burden when measuring medication adherence lies in the use of computer‐adaptive tests (CATs) or in the development of shorter patient-reported outcome measures (PROMs). However, the lack of an item bank currently hampers this progress. Objective We aim to develop an item bank to measure general medication adherence. Methods Using the preferred reporting items for systematic review and meta-analysis (PRISMA), articles published before October 2019 were retrieved from PubMed, Embase, CINAHL, the Cochrane Library, and Web of Science. Items from existing PROMs were classified and selected (“binned” and “winnowed”) according to standards published by the Patient-Reported Outcomes Measurement Information System (PROMIS) Cooperative Group. Results A total of 126 unique PROMs were identified from 213 studies in 48 countries. Items from the literature review (47 PROMs with 579 items for which permission has been obtained) underwent binning and winnowing. This resulted in 421 candidate items (77 extent of adherence and 344 reasons for adherence). Conclusions We developed an item bank for measuring general medication adherence using items from validated PROMs. This will allow researchers to create new PROMs from selected items and provide the foundation to develop CATs.
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Affiliation(s)
- Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Livia Jia Yi Oo
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Dionne Hui Fang Loh
- PULSES Centre Grant, SingHealth Regional Health System, Singapore, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Si Dun Weng
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Dan V Blalock
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Eng Hui Chew
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Kai Zhen Yap
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Corrinne Yong Koon Tan
- Pharmacy Transformation Office, National Healthcare Group Pharmacy, Singapore, Singapore
| | - Sungwon Yoon
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,PULSES Centre Grant, SingHealth Regional Health System, Singapore, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Truls Østbye
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Lian Leng Low
- PULSES Centre Grant, SingHealth Regional Health System, Singapore, Singapore.,Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, Singapore.,Post Acute and Continuing Care, Outram Community Hospital, Singapore, Singapore
| | - Hayden Barry Bosworth
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States.,School of Nursing, Duke University Medical Center, Durham, NC, United States.,Department of Population Health Sciences, Duke University Medical Center, Durham, NC, United States
| | - Julian Thumboo
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Impact of adherence to warfarin therapy during 12 weeks of pharmaceutical care in patients with poor time in the therapeutic range. J Thromb Thrombolysis 2020; 51:1043-1049. [PMID: 32974757 DOI: 10.1007/s11239-020-02280-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 01/17/2023]
Abstract
Poor adherence to warfarin treatment is a contributor to poor quality of treatment, which increases the risk of bleeding and thromboembolic events. This study aims to evaluate the impact of adherence to warfarin therapy on anticoagulation quality during 12 weeks of pharmaceutical care and after 1 year of follow-up for patients with atrial fibrillation and with poor TTR. The Arrhythmia Unit of tertiary hospital in Brazil. We included 262 patients with AF and poor quality of anticoagulation therapy with warfarin (TTR < 50%). Pharmacist-driven therapy management was performed for 12 weeks and patients were also evaluated 1 year after the end of the follow-up with a pharmacist. Adherence was classified into high adherence, medium adherence and low adherence. Impact of adherence to warfarin therapy after pharmaceutical care. Of the 262 patients, 160 were high adherence, 71 were medium adherence and 31 were low adherence. No statistically significant difference is found between adherence groups in demographic and clinical variables. The TTR basal means were not different among adherence groups (p = 0.386). However, the means of TTR 12 weeks and TTR 1 year after the end of protocol were statistically different among adherence groups (p < 0.001 and p = 0.002, respectively). When we compared TTR values at different times within the adherence group, we observed that there is a statistical difference between the three TTR means (basal versus 12 weeks versus 1 year after) within the adherence group (p < 0.001). Patients with poor anticoagulation control, who adhered to the treatment with warfarin during the pharmaceutical care had better anticoagulation quality compared to those who did not adhere to the therapy with warfarin.
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Shilbayeh SAR, Ibrahim AA. The anti-clot treatment scale (ACTS): validation of the translated Arabic version among patients undergoing warfarin therapy in Saudi Arabia. Health Qual Life Outcomes 2020; 18:215. [PMID: 32631346 PMCID: PMC7339378 DOI: 10.1186/s12955-020-01471-4] [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] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background Long-term anticoagulation therapy, particularly with warfarin, is usually associated with poor adherence and low patient satisfaction. However, previous studies have highlighted the possibility that individual perceptions of warfarin differ according to cultural practices. This study validated the psychometric properties of the translated Arabic version of the Anti-Clot Treatment Scale (ACTS) for patients on warfarin therapy in Saudi Arabia. Methods A cross-sectional multicenter study was conducted at the three main medical centers in Riyadh. Stratified sampling was employed to recruit Arabic-speaking patients who had been taking warfarin for a minimum of 3 months for any indication. The patients completed the specific ACTS along with the generic Treatment Satisfaction Questionnaire for Medication (TSQM 1.4) at two clinic visits. The psychometric performance of the ACTS was evaluated using well-established criteria: feasibility, reliability, and validity. Results One hundred thirty-six patients participated in the study (mean age: 50.68 ± 14.6 years; range: 19–97). Overall, the patients reported moderate Burdens and Benefits scores (44 ± 9.9 and 11.92 ± 2.4, respectively) compared to the reference range for each subscale (12–60 and 3–15, respectively); however, they reported lower Burdens scores than other populations. Consistent with the original ACTS validation study, the criteria for acceptability (data targeting, floor/ceiling effects, and skewness) were satisfied; in fact, the Arabic version exhibited better item- and scale-level distributions of data than versions in other languages. The ACTS subscales also demonstrated satisfactory test-retest reliability with significant intraclass correlation coefficients ((ICC ≥ 0.5); p < 0.001) and good internal consistency (all Cronbach’s alpha values exceeded 0.7). Exploratory factor analysis supported the 2-factor loading model. Interestingly, the Arabic version exhibited greater convergent validity with the TSQM subdomains (r = 0.61). Conclusions This study provides convincing evidence that the Arabic versions of both the ACTS Burdens and ACTS Benefits scales are equivalent to other versions in terms of psychometric performance, as measured using reliability and validity criteria. These properties support the great potential of the Arabic ACTS to accurately reflect patient satisfaction, identify aspects of treatment that need improvement in clinical practice, and compare treatment satisfaction across different anticoagulant therapies or cultures in research.
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Affiliation(s)
- Sireen Abdul Rahim Shilbayeh
- Department of Pharmaceutical Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
| | - Alnada Abdalla Ibrahim
- Department of Pharmaceutical Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
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Naqvi AA, AlShayban DM, Ghori SA, Mahmoud MA, Haseeb A, Faidah HS, Hassali MA. Validation of the General Medication Adherence Scale in Saudi Patients With Chronic Diseases. Front Pharmacol 2019; 10:633. [PMID: 31231222 PMCID: PMC6558415 DOI: 10.3389/fphar.2019.00633] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 05/17/2019] [Indexed: 12/27/2022] Open
Abstract
Objective: The aim was to validate the General Medication Adherence Scale (GMAS) (English version) in Saudi patients with chronic disease. Methods: A month-long study was conducted in the out-patient department of tertiary care hospitals in three cities of Saudi Arabia that collected data from a randomized sample of Saudi patients with chronic disease. The study aimed to achieve an item-to-subject ratio greater than 1:10. Factor analyses were conducted and fit indices calculated. Convergent, discriminant, known group, and concurrent validities were analysed. Internal consistency was determined using test-retest reliability using Cronbach's alpha (α), McDonald's coefficient omega (ω t ), and Pearson's correlation coefficient (ρ). Sensitivity analysis was conducted. Data were analysed through Statistical Package for Social Sciences (SPSS) version 23. The study was ethically approved (i.e., IRB-129-26/6/1439). Results: The survey gathered responses from 171 patients with a response rate of 85.5%. An item-to-subject ratio of 1:15 was achieved. Factor analysis revealed a three-factor structure with acceptable fit indices (i.e., normed fit index (NFI) = 0.93, Tucker-Lewis index (TLI) = 0.99, and comparative fit index (CFI) = 0.99), i.e., greater than 0.9. The value of root mean square error of approximation (RMSEA) was 0.01, i.e., less than 0.08. The tool established construct validity, i.e., convergent and discriminant validities. Known group and concurrent validities were also established. An α value of 0.74 and ω t value of 0.92 were reported. Test-retest reliability ρ = 0.82, p < 0.001. The tool had high sensitivity (>75%) and specificity (>80%). Conclusion: The GMAS-English was successfully validated in Saudi patients with chronic disease.
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Affiliation(s)
- Atta Abbas Naqvi
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Dhafer Mahdi AlShayban
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Syed Azizullah Ghori
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mansour Adam Mahmoud
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Medina, Saudi Arabia
| | - Abdul Haseeb
- Department of Pharmacy Practice, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Hani Saleh Faidah
- Department of Microbiology, Faculty of Medicine, Umm Al Qura University, Makkah, Saudi Arabia
| | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Farouk F, Nabhan S, Niessen WM, Azzazy HM. LC–MS/MS assay for assessing medical adherence in patients under warfarin maintenance therapy. Microchem J 2018. [DOI: 10.1016/j.microc.2018.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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