Self‐reported adherence by <scp>MARS</scp>‐<scp>CZ</scp> reflects <scp>LDL</scp> cholesterol goal achievement among statin users: validation study in the <scp>C</scp>zech <scp>R</scp>epublic

Ládová, Kateřina; Matoulková, Petra; Zadák, Z; Macek, Karel; Vyroubal, Pavel; Vlcek, Jirí; Morisky, Donald E.

doi:10.1111/jep.12201

Cited by 12 publications

(13 citation statements)

References 37 publications

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“…In our study, full adherence was reported by >80% of all respondents, and only 2.8% of them had <23 points. Similar results were found in another study from the Czech Republic, in which the MARS-CZ was used to determine self-reported adherence to statins 10. Similar findings to ours were also observed with other scales (eg, the Basel Assessment of Adherence with Immunosuppressive Medication Scales), even if a less strict scoring method was used 20,21.…”

Section: Discussionsupporting

confidence: 89%

“…Patients were also asked to rate their health status using the 5-point Likert scale. Self-reported medication adherence was measured by the Czech version of the Medication Adherence Report Scale (MARS-CZ), which was validated in an interview 10. The MARS-CZ can be employed in various diseases with similar dosing regimen, as the items are focused on the patients’ intentional or unintentional changes in prescribed dosages.…”

Section: Methodsmentioning

confidence: 99%

“…The continuous score (0–25 points) was combined with dichotomous variables using the cut-point of 23 points to determine high (≥23 points) and low (<23 points) level of adherence. This cut-point was preferred in studies requiring the patients’ strict medication adherence, established in agreement with the Czech validation study 10. The BMQ-CZ consists of 11 statements concerning personal beliefs about the necessity of the medication, as well as their concerns regarding potential adverse effects.…”

Section: Methodsmentioning

confidence: 99%

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Immunosuppressive therapy related adherence, beliefs and self-management in kidney transplant outpatients

Vaňková

Malá‐Ládová

Kubêna

et al. 2018

PPA

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PurposeKidney transplant (KTx) recipients should strictly adhere to their lifelong complex therapeutic regimen, and any barriers to medication adherence can weaken correct patient behavior. This study aimed to determine the adherence to immunosuppressive therapy (IS) in KTx adult outpatients in the Czech Republic, and attempted to gain a greater insight into their attitudes toward IS and self-management tasks.Materials and methodsPharmacist-led structured interviews were conducted to assess self-reported adherence to IS using the Czech version of the Medication Adherence Report Scale, in the context of attitudes toward IS in terms of necessity and concern scale of the Beliefs about Medicines Questionnaire. A specific questionnaire was developed to target IS self-management tasks. Medication records were also reviewed for IS serum levels, reflecting direct adherence measurement. Descriptive statistics were used to calculate adherence and self-management variables, and were analyzed by univariate and multivariate correlations, including the decision-tree method.ResultsThe interview was completed by 211 (male 123; mean age 55.0±12.4 years, mean time 6.6±5.9 years after KTx) of the total of 235 patients. Full adherence to IS was reported by 173 (82.0%) patients. Most of them had IS serum levels within the therapeutic range, however, cyclosporine was associated with the highest variability (P<0.001). Non-adherence and concerns increased over time after KTx (P<0.05). Despite the more common unintentional non-adherence (P<0.001), relatively high concerns signified the risk of not taking IS as prescribed. Concerns also correlated with the perception of impaired health status (P<0.01), as well as the occurrence of IS-related adverse effects (P<0.001). The patients’ awareness of their therapy was insufficient, and main gaps in self-management comprised inadequate sun protection, incorrect administration of IS, and unfamiliarity with the IS name, or their indications.ConclusionAlthough self-reported adherence to IS therapy was satisfactory, the comprehensive evaluation enabled the detection of greater concerns about IS, as well as underestimated self-management tasks that posttransplant interventions should target in the future.

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Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Immunosuppressive therapy related adherence, beliefs and self-management in kidney transplant outpatients

Vaňková

Malá‐Ládová

Kubêna

et al. 2018

PPA

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“…It is a generic tool, which can be administered regardless of the disease and the prescribed drug. It has been validated so far in different clinical settings, namely statin therapy [15], rheumatoid arthritis [16], asthma [17], psychosis [18], and has been used for assessing adherence in many clinical studies worldwide [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37].…”

Section: Introductionmentioning

confidence: 99%

Translation and initial validation of the Medication Adherence Report Scale (MARS) in Italian patients with Crohn’s Disease

Scribano

Caprioli

Michielan

et al. 2019

Digestive and Liver Disease

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The MARS-5 (Medication Adherence Report Scale) was developed in English. The aim of this project was to analyse the MARS-5I (© Prof Rob Horne) psychometric properties and to identify whether its Italian translation is suitable for assessing medication adherence in Crohn Disease (CD) Italian patients. The MARS was translated and linguistically validated in Italian. The MARS-5I was used for evaluating medication adherence in the SOLE study, conducted in Italy on 552 subjects with CD. In order to unbias the questionnaire results from the effects of treatment change and/or effectiveness, the analyses were performed on the 277 patients whose disease activity remained stable, selected among the 371 patients who maintained the same treatment between two consecutive visits. Internal consistency was high (Cronbach's alpha of 0.86). Pearson's correlation coefficient was 0.50 (p < 0.001) and 0.86 (p < 0.001outliers removed), indicating satisfactory test-retest. MARS 5I scores were not correlated with Treatment Satisfaction Questionnaire for Medication but a small and statistically significant correlation was shown with physician-evaluated medication adherence, indicating convergent validity. MARS-5I, the Italian translation of the English MARS, showed satisfactory internal consistency and test-retest, and a low but statistically significant convergent validity. We confirmed the utility of this tool in patients with CD.

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“…Despite anonymity of the respondent, self-reported quantitative compliance (questions on doses used or missed) was almost always very high. 15 , 30 – 32 Social desirability is probably the dominant reason why our participants not only overrated their compliance by the questionnaire, but also spilled tablets out of MEMS and returned empty containers in most cases. Hawthorne effect refers to those patients who overestimate their adherence when they know they are monitored.…”

Section: Discussionmentioning

confidence: 92%

Drug holidays: the most frequent type of noncompliance with calcium plus vitamin D supplementation in persistent patients with osteoporosis

Touskova¹,

Vytrisalova²,

Palička³

et al. 2015

PPA

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PurposeAll current recommendations include calcium and vitamin D (Ca–D) as an integrated part of osteoporosis treatment. The purpose of this pilot study was to analyze compliance with a fixed combination of Ca–D in women persistent with the treatment.Patients and methodsAn observational study was carried out in three osteocenters in the Czech Republic. Women with osteoporosis ≥55 years of age concurrently treated with oral ibandronate were eligible. Compliance was evaluated in a period of 3 months by Medication Event Monitoring System (MEMS), tablet count, and self-report. Nonpersistence was defined as a MEMS-based gap in the use of Ca–D to be 30 days or more.ResultsA total of 73 patients were monitored, of which 49 patients were analyzed (target population). Based on MEMS, mean overall compliance was 71%; good compliance (≥80%) was observed in 59% of the patients. As many as 71% of the patients took drug holidays (≥3 consecutive days without intake); overall compliance of these patients was 59% and was slightly lower on Fridays and weekends. Patients without drug holidays were fully compliant (did not omit individual doses). Compliance differed according to daily time at which the patients mostly used the Ca–D. Afternoon/evening takers showed a mean overall compliance of 82% while morning/night takers only 51% (P=0.049). Based on MEMS, tablet count, and self-report, compliance ≥75% was observed in 59%, 100%, and 87% of the patients, respectively. Outcomes obtained by the three methods were not associated with each other. Undesirable concurrent ingestion of Ca–D and ibandronate was present only twice.ConclusionDespite almost perfect self-reported and tablet count-based compliance, MEMS-based compliance was relatively poor. Consecutive supplementation-free days were common; more than two-thirds of the patients took at least one drug holiday. This pilot study showed drug holiday to be the most important type of noncompliance with Ca–D in those who are persistent with the treatment.

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Self‐reported adherence by MARS‐CZ reflects LDL cholesterol goal achievement among statin users: validation study in the Czech Republic

Abstract: This study proved MARS-CZ as an acceptable self-reported adherence measure. In routine clinical practice, MARS-CZ could be helpful to reveal medication non-adherence before the alteration of drug regimen and thereby contributing to enhancement of statin therapy management.

Cited by 12 publications

References 37 publications

Immunosuppressive therapy related adherence, beliefs and self-management in kidney transplant outpatients

Immunosuppressive therapy related adherence, beliefs and self-management in kidney transplant outpatients

Translation and initial validation of the Medication Adherence Report Scale (MARS) in Italian patients with Crohn’s Disease

Drug holidays: the most frequent type of noncompliance with calcium plus vitamin D supplementation in persistent patients with osteoporosis

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