Patient‐reported outcome instruments that evaluate adherence behaviours in adults with asthma: a systematic review of measurement properties

Gagné, Myriam; Boulet, Louis‐Philippe; Pérez, Norma; Moisan, Jocelyne

doi:10.1111/bcp.13623

Cited by 12 publications

(8 citation statements)

References 42 publications

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“…A number of previous studies have been conducted to validate PROMs on medication adherence [ 12 , 15 - 17 ], and a previous systematic review found 14 PROMs that assessed adherence to inhaled asthma maintenance medication alone [ 18 ]. However, to date, there is no comprehensive review that summarizes the psychometric properties of PROMs for medication adherence, which is essential to guide the selection of suitable PROMs to evaluate medication adherence in patients.…”

Section: Introductionmentioning

confidence: 99%

Measurement Properties of Existing Patient-Reported Outcome Measures on Medication Adherence: Systematic Review

Kwan¹,

Weng²,

Loh³

et al. 2020

J Med Internet Res

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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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Section: Introductionmentioning

confidence: 99%

Measurement Properties of Existing Patient-Reported Outcome Measures on Medication Adherence: Systematic Review

Kwan¹,

Weng²,

Loh³

et al. 2020

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…PROMs are insufficient at tracking asthma medication adherence compared with objective measures, such as prescription refill rates. In a systematic review of 14 PROMs designed to evaluate inhaler medication adherence in adults with asthma, there was no evidence that they could detect changes in adherence scores over time [33]. Thus, these tools cannot fully distinguish whether uncontrolled symptoms are caused by medication nonadherence versus truly refractory disease.…”

Section: Medication Adherencementioning

confidence: 99%

Asthma diagnosis using patient-reported outcome measures and objective diagnostic tests: now and into the future

Nawaz

Ravindran²,

Kuruvilla

2022

Current Opinion in Pulmonary Medicine

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Purpose of reviewThe global prevalence of asthma continues to increase; however, asthma remains under-diagnosed and under-treated. This results in a significant burden on the healthcare system and preventable patient morbidity and mortality. Over-diagnosis of asthma based on clinical history alone also complicates patient management. This heightens the importance of a prompt and accurate asthma diagnosis. Therefore, a review of the literature was performed regarding both objective diagnostic testing for asthma and using patient-reported outcome measures. Recent findingsThe cornerstone of asthma diagnosis remains spirometry with testing for bronchodilator reversibility testing for pediatric and adult populations. This test may need to be repeated at multiple time points due to its low sensitivity. Peak flow measurement, fractional exhaled nitric oxide testing, and allergy testing are useful adjuncts to the diagnosis and phenotyping of asthma. Bronchoprovocation testing is reserved for people with high clinical suspicion for asthma, but negative spirometry. Novel noninvasive testing modalities may play a diagnostic role in the future. The advent of remote digital health monitoring technology has resulted in revisiting patient-reported outcome measures for the diagnosis and monitoring of asthma. SummaryOverall, improved diagnostic tools for asthma are crucial for earlier recognition and treatment of the disease and improved patient care outcomes worldwide.

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“…A recent systematic review of patient-reported outcome instruments to evaluate adherence in adults with asthma concluded the evidence was mixed or unknown regarding the reliability and validity of currently available tools, but that there was no evidence of the responsiveness of any available instrument, and no recommendation could be made regarding the use of a particular tool in routine care or in research settings [ 35 ].…”

Section: Measuring and Identifying Non-adherencementioning

confidence: 99%

Measuring adherence to therapy in airways disease

Holmes

Heaney

2021

Breathe

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Non-adherence to medication is one of the most significant issues in all airways disease and can have a major impact on disease control as well as on unscheduled healthcare utilisation. It is vital that clinicians can accurately determine a patient's level of adherence in order to ensure they are gaining the maximal benefit from their therapy and also to avoid any potential for unnecessary increases in therapy. It is essential that measurements of adherence are interpreted alongside biomarkers of mechanistic pathways to identify if improvements in medication adherence can influence disease control.In this review, the most common methods of measuring adherence are discussed. These include patient self-report, prescription record checks, canister weighing, dose counting, monitoring drug levels and electronic monitoring. We describe the uses and benefits of each method as well as potential shortcomings. The practical use of adherence measures with measurable markers of disease control is also discussed.Educational aimsTo understand the various methods available to measure adherence in airways disease.To learn how to apply these adherence measures in conjunction with clinical biomarkers in routine clinical care.

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Patient‐reported outcome instruments that evaluate adherence behaviours in adults with asthma: a systematic review of measurement properties

Abstract: Our results highlighted the need to conduct further high-quality studies to evaluate the reliability, validity and responsiveness of the available PROs.

Cited by 12 publications

References 42 publications

Measurement Properties of Existing Patient-Reported Outcome Measures on Medication Adherence: Systematic Review

Measurement Properties of Existing Patient-Reported Outcome Measures on Medication Adherence: Systematic Review

Asthma diagnosis using patient-reported outcome measures and objective diagnostic tests: now and into the future

Measuring adherence to therapy in airways disease

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