SPUR: psychometric properties of a patient-reported outcome measure of medication adherence in type 2 diabetes

Wells, Joshua; Husseini, Aya El; Okoh, Sandra; Jaffar, Ali; Neely, Claire; Crilly, Philip; Dolgin, Kevin; Kayyali, Reem

doi:10.1136/bmjopen-2021-058467

Cited by 2 publications

(10 citation statements)

References 37 publications

(56 reference statements)

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“…This follow-up cross-sectional study to VMATT2 23 was conducted in a hospital inpatient setting in London, England, from January to December 2021. The study (VMATC) protocol and relevant documentation were submitted via IRAS (ID:285590) for review with approval received from the NHS Health Research Authority (HRA) research ethics committee (20/NW/0485) in January 2021.…”

Section: Study Aim Design and Ethical Approvalmentioning

confidence: 99%

“…The English version of the original 45-item SPUR was used in the study, with the methods for development of the model being reported previously. 19,23 The tool is a holistic PROM of MA that contains generic wording which can be adapted for use with target chronic conditions; hence, this study replaced "type 2 diabetes" with "COPD" throughout the 45-item instrument. However, previous work by Wells et al 23 provided evidence for the psychometric properties of a more concise 27-item version of the main questionnaire titled, SPUR-27.…”

Section: Research Instrumentmentioning

confidence: 99%

“…19,23 The tool is a holistic PROM of MA that contains generic wording which can be adapted for use with target chronic conditions; hence, this study replaced "type 2 diabetes" with "COPD" throughout the 45-item instrument. However, previous work by Wells et al 23 provided evidence for the psychometric properties of a more concise 27-item version of the main questionnaire titled, SPUR-27. Therefore, only the results for SPUR-27 tool (derived from completion of the original 45-item SPUR questionnaire) were evaluated in patients living with COPD.…”

Section: Research Instrumentmentioning

confidence: 99%

“…19,20 The four key domains of MA termed Social, Psychographic, Usage, and Rational comprise the 45-item measure and can be used to evaluate individual factors and behaviours related to non-adherence. 21,22 Recently, a shorter 27-item version of the SPUR tool (SPUR-27) was validated for patients living with type 2 diabetes in a UK study by Wells et al 23 The revised 27-item model demonstrated greater reliability than the original SPUR-45 tool as well as significant correlations with objective and PROMs of MA in addition to socio-clinical factors such as body mass index (BMI) and income. The psychometric properties of the tool, as well as its relationship to patient socio-clinical factors, have yet to be evaluated in patients living with COPD.…”

Section: Introductionmentioning

confidence: 99%

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SPUR-27 – Psychometric Properties of a Patient-Reported Outcome Measure of Medication Adherence in Chronic Obstructive Pulmonary Disease

Wells¹,

Mahendran²,

Dolgin³

et al. 2023

PPA

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People living with COPD who struggle to take their medicines often experience poorer health outcomes such as exacerbations of symptoms, more frequent and lengthy hospital admissions, and worsening mortality rates. This study aimed to evaluate the psychometric properties of the previously validated SPUR-27 model, a multi-factorial model of medication adherence. Patients and Methods: This cross-sectional study was conducted with 100 adult patients living with COPD in a hospital setting in Southwest London. Medication adherence was assessed using a shortened SPUR model (SPUR-27) against the validated Inhaler Adherence Scale (IAS) as a comparator. In addition, objective medication adherence data, presented as the Medication Possession Ratio (MPR), were derived from patient medical and pharmacy records. The COPD Assessment Tool (CAT) score was used to examine the relationship between medication adherence and COPD symptom severity. Reliability of SPUR-27 was assessed using internal consistency estimates. Exploratory factor analysis, partial confirmatory factor analysis, and maximum likelihood analysis were conducted in conjunction with construct, concurrent, and known-group validity testing to explore the psychometric properties of the SPUR model in this population. Results: A 7-factor model for SPUR-27 was derived with adequate factor loadings. SPUR (α=0.893) observed strong internal consistency (>0.8). The model was significantly positively correlated with IAS score (p<0.001) as well as MPR (p<0.01). A significant (p<0.01) relationship between poor medication adherence and worsening symptom severity, as defined by the CAT score, was identified for SPUR (χ 2 = 8.570) using Chi-Square analysis. Furthermore, SPUR-27 demonstrated early evidence of validity with good incremental fit indices: NFI (0.96), TFI (0.97), and CFI (0.93) were all reported as >0.9 in addition to the RMSEA, which was <0.08 (0.059). Conclusion: SPUR demonstrated strong psychometric properties in patients living with COPD. Further work should look to examine the test-retest reliability of the model and its application in broader sample populations.

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Section: Study Aim Design and Ethical Approvalmentioning

confidence: 99%

Section: Research Instrumentmentioning

confidence: 99%

Section: Research Instrumentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

SPUR-27 – Psychometric Properties of a Patient-Reported Outcome Measure of Medication Adherence in Chronic Obstructive Pulmonary Disease

Wells¹,

Mahendran²,

Dolgin³

et al. 2023

PPA

Self Cite

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“…The proposed SPUR model framework 31 and initial model development 32 process have been reported previously. Furthermore, psychometric properties for populations based in the US 33 and France 34 have been reported, in addition to a UK-based cohort of patients living with type 2 diabetes (VMATT2) 35 that produced a more concise SPUR tool – SPUR-27. This study sought to develop a predictive model of early readmission and general admission risk using the SPUR-27 tool as a holistic PROM of medication adherence.…”

Section: Introductionmentioning

confidence: 99%

SPUR: A Patient-Reported Medication Adherence Model as a Predictor of Admission and Early Readmission in Patients Living with Type 2 Diabetes

Wells¹,

Wang²,

Dolgin³

et al. 2023

PPA

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Purpose Poor medication adherence (MA) is linked to an increased likelihood of hospital admission. Early interventions to address MA may reduce this risk and associated health-care costs. This study aimed to evaluate a holistic Patient Reported Outcome Measure (PROM) of MA, known as SPUR, as a predictor of general admission and early readmission in patients living with Type 2 Diabetes. Patients and Methods An observational study design was used to assess data collected over a 12-month period including 6-month retrospective and 6-month prospective monitoring of the number of admissions and early readmissions (admissions occurring within 30 days of discharge) across the cohort. Patients (n = 200) were recruited from a large South London NHS Trust. Covariates of interest included: age, ethnicity, gender, level of education, income, the number of medicines and medical conditions, and a Covid-19 diagnosis. A Poisson or negative binomial model was employed for count outcomes, with the exponentiated coefficient indicating incident ratios (IR) [95% CI]. For binary outcomes (Coefficient, [95% CI]), a logistic regression model was developed. Results Higher SPUR scores (increased adherence) were significantly associated with a lower number of admissions (IR = 0.98, [0.96, 1.00]). The number of medical conditions (IR = 1.07, [1.01, 1.13]), age ≥80 years (IR = 5.18, [1.01, 26.55]), a positive Covid-19 diagnosis during follow-up (IR = 1.83, [1.11, 3.02]) and GCSE education (IR = 2.11, [1.15,3.87]) were factors associated with a greater risk of admission. When modelled as a binary variable, only the SPUR score (−0.051, [−0.094, −0.007]) was significantly predictive of an early readmission, with patients reporting higher SPUR scores being less likely to experience an early readmission. Conclusion Higher levels of MA, as determined by SPUR, were significantly associated with a lower risk of general admissions and early readmissions among patients living with Type 2 Diabetes.

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SPUR: psychometric properties of a patient-reported outcome measure of medication adherence in type 2 diabetes

Cited by 2 publications

References 37 publications

SPUR-27 – Psychometric Properties of a Patient-Reported Outcome Measure of Medication Adherence in Chronic Obstructive Pulmonary Disease

SPUR-27 – Psychometric Properties of a Patient-Reported Outcome Measure of Medication Adherence in Chronic Obstructive Pulmonary Disease

SPUR: A Patient-Reported Medication Adherence Model as a Predictor of Admission and Early Readmission in Patients Living with Type 2 Diabetes

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