8.2.2 Flashcards
What is self-report in measuring non-adherence?
It involves patients completing questionnaires about their adherence to treatment, such as the Medication Adherence Report Scale (MARS).
What format does the Medication Adherence Report Scale (MARS) use?
A forced-choice yes/no format.
List three advantages of using self-report to measure adherence.
It is cheap, quick, and can collect data from a large number of people, increasing generalizability.
What are two main disadvantages of self-report methods?
They rely on patient memory (reducing reliability) and are subject to social desirability bias (reducing validity).
What is a semi-structured clinical interview in the context of non-adherence measurement?
A focused dialogue between the patient and practitioner designed to elicit details about adherence.
What is the Medical Adherence Measure (MAM)?
A tool designed to obtain adherence details from patients through clinical interviews.
Why is the success of a semi-structured interview dependent on the patient-practitioner relationship?
Patients are more likely to be honest if they feel comfortable with the practitioner.
What are two strengths of semi-structured interviews in adherence research?
They provide detailed qualitative data, increasing validity and usefulness.
List three disadvantages of semi-structured interviews.
They are time-consuming, expensive, and have a high drop-out rate, leading to lower generalizability.
What was the aim of Riekert and Drotar’s (1999) study?
To assess the implications of non/incomplete participation of adolescents with diabetes in treatment adherence research.
What was the sample size of the study?
Initially 94 families, but only 52 completed the study.
What method did the researchers use to assess adherence?
The Adherence and IDDM Questionnaire-R, interviews, and monitoring blood glucose levels using a reflectance meter.
What were the main findings of Riekert and Drotar’s study?
Adolescents who did not return questionnaires had significantly lower adherence than those who completed them.
What was the main conclusion of the study?
Lower adolescent adherence is associated with lower participation in adherence research.
How is pill counting used to measure adherence?
Patients bring their medication to the clinic, where the remaining pills are counted.
How can unannounced pill counts improve validity?
By conducting telephone or home visits, researchers can prevent patient manipulation of pill counts.
What study supports the validity of pill counting?
Kalichman et al. (2008) found a 92% agreement between telephone/home pill counts and viral load measures in HIV+ patients.
What are two disadvantages of pill counting?
It is burdensome for patients who must bring medication to appointments, and patients may manipulate the pill count if they know the date and time.
What are medication dispensers
and how do they work?
What is a major advantage of medication dispensers for patients?
They serve as reminders, reducing forgetfulness and preventing relapse.
Why do medication dispensers lack validity in adherence measurement?
Just because a pill is removed does not mean it has been taken.
What type of non-adherence do medication dispensers help reduce?
Unintentional non-adherence caused by forgetfulness.
What was the aim of Chung and Naya (2000)?
To electronically assess compliance with an oral asthma medication.
What technology did they use to track medication adherence?
TrackCap, which recorded the date and time the pill bottle was opened.
What was the sample size and age range?
47 asthma patients aged 18–55.
What were the compliance rates found using TrackCap and pill count?
80% compliance with TrackCap and 89% compliance with pill count.
What was a key issue found in the study?
20% of participants under-complied by only removing one tablet daily instead of two.
What was the main conclusion?
Monitoring systems like TrackCap effectively measure adherence but may not reflect actual medication intake.
Why is urine analysis used to measure adherence?
It provides objective visual results of medication presence in the body.
List two advantages of urine analysis.
It is cheap, non-invasive, and chemically stable for 14 days under refrigeration.
What is a major disadvantage of urine analysis?
Drug/drug and drug/food interactions can interfere with accuracy.
What are the two main methods of blood sampling for adherence testing?
Traditional blood sampling and dried blood spot (DBS) testing.
What did Burnier (2020) find about DBS testing?
DBS can measure hypertension drugs as reliably as traditional plasma testing.
Why is DBS testing preferred over traditional blood sampling?
It is less stressful and invasive for patients.
What is a disadvantage of traditional blood sampling?
It is invasive and can be stressful for some patients.
How does Riekert and Drotar’s study apply to real life?
It shows that families who do not complete research tasks may lack organizational skills, helping design adherence interventions.
Why is the Chung and Naya study relevant to real-life adherence?
It measured adherence in home settings where patients normally take medication.
What ethical issue is raised by Riekert and Drotar (1999)?
They used data from non-consenters, raising concerns about informed consent.
What ethical issue is raised by Chung and Naya (2000)?
Patients were deceived about how their medication adherence was monitored.
Why is electronic monitoring considered more valid than self-report?
It eliminates social desirability bias and memory errors.
What was the main methodological strength of Riekert and Drotar’s study?
They used method triangulation, combining qualitative and quantitative data.
Why was Chung and Naya’s study potentially lacking in validity?
Participants knew their adherence was being measured, which may have influenced behavior.
How can research into non-adherence improve the medical profession?
It helps identify reasons for non-adherence and develop strategies to improve adherence.
