基于自我报告的依从性测量结果与基于药房记录的测量结果一致性较差。

Measures of adherence based on self-report exhibited poor agreement with those based on pharmacy records.

作者信息

Guénette Line, Moisan Jocelyne, Préville Michel, Boyer Richard

机构信息

Faculté de pharmacie, Université Laval, and Unité de recherche en santé des populations, Hôpital Saint-Sacrement du CHA, 1050, chemin Sainte-Foy, Québec, QC G1S 4L8 Canada.

出版信息

J Clin Epidemiol. 2005 Sep;58(9):924-33. doi: 10.1016/j.jclinepi.2005.02.002.

DOI:10.1016/j.jclinepi.2005.02.002

PMID:16085196

Abstract

OBJECTIVE

To assess the level of agreement between a self-reported measure of adherence with prescribed drug and a measure of adherence based on pharmacy data.

METHODS

During an in-home interview, people aged 65+ were asked to report all prescription drugs they had taken in the preceding month. For each drug, a four-item questionnaire was used to determine self-reported adherence. In the pharmacy records, each drug that had been filled at least four times was analyzed, and the percentage of days with the drug available was calculated. Two types of adherence were studied: (1) adherence by individual, and (2) adherence by drug. The level of agreement was assessed using kappa (kappa) statistics and proportions of agreement.

RESULTS

We compared the adherence measures among 189 individuals (880 drugs). Among all, 90 individuals (48%) self-reported adherence, whereas 95 individuals (50%) were adherent according to the records. The level of agreement between these two measures was slight (kappa=0.16 [95% CI: 0.02-0.30]). Individuals self-reported to be adherent for 81% of the drugs, while pharmacy records showed adherence for 83% of them (kappa=0.13 [95% CI: 0.05-0.20]).

CONCLUSION

Self-reported measures of adherence exhibited poor agreement with those based on pharmacy records.

摘要

目的

评估自我报告的处方药依从性测量方法与基于药房数据的依从性测量方法之间的一致性水平。

方法

在一次家庭访谈中，询问65岁及以上的人群他们在前一个月服用的所有处方药。对于每种药物，使用一份包含四个条目的问卷来确定自我报告的依从性。在药房记录中，分析每种至少配药四次的药物，并计算有药可用的天数百分比。研究了两种类型的依从性：（1）个体依从性，以及（2）药物依从性。使用kappa统计量和一致性比例来评估一致性水平。

结果

我们比较了189名个体（880种药物）的依从性测量结果。其中，90名个体（48%）自我报告依从，而根据记录有95名个体（50%）依从。这两种测量方法之间的一致性水平较低（kappa=0.16[95%置信区间：0.02 - 0.30]）。个体自我报告对81%的药物依从，而药房记录显示83%的药物依从（kappa=0.13[95%置信区间：0.05 - 0.20]）。