门诊环境中药物依从性测量的预测效度。
Predictive validity of a medication adherence measure in an outpatient setting.
作者信息
Morisky Donald E, Ang Alfonso, Krousel-Wood Marie, Ward Harry J
机构信息
Department of Community Health Sciences, UCLA School of Public Health, Los Angeles, CA 90095-1772, USA.
出版信息
J Clin Hypertens (Greenwich). 2008 May;10(5):348-54. doi: 10.1111/j.1751-7176.2008.07572.x.
This study examines the psychometric properties and tests the concurrent and predictive validity of a structured, self-reported medication adherence measure in patients with hypertension. The authors also assessed various psychosocial determinants of adherence, such as knowledge, social support, satisfaction with care, and complexity of the medical regimen. A total of 1367 patients participated in the study; mean age was 52.5 years, 40.8% were male, 76.5% were black, 50.8% graduated from high school, 26% were married, and 54.1% had income <$5,000. The 8-item medication adherence scale was reliable (alpha=.83) and significantly associated with blood pressure control (P<.05). Using a cutpoint of <6, the sensitivity of the measure to identify patients with poor blood pressure control was estimated to be 93%, and the specificity was 53%. The medication adherence measure proved to be reliable, with good concurrent and predictive validity in primarily low-income, minority patients with hypertension and might function as a screening tool in outpatient settings with other patient groups.
本研究考察了一种结构化的、自我报告的高血压患者药物依从性测量方法的心理测量特性，并测试了其同时效度和预测效度。作者还评估了依从性的各种心理社会决定因素，如知识、社会支持、对治疗的满意度以及医疗方案的复杂性。共有1367名患者参与了该研究；平均年龄为52.5岁，40.8%为男性，76.5%为黑人，50.8%高中毕业，26%已婚，54.1%收入低于5000美元。这个8项的药物依从性量表是可靠的（α = 0.83），并与血压控制显著相关（P < 0.05）。使用<6的切点，该测量方法识别血压控制不佳患者的敏感性估计为93%，特异性为53%。在主要为低收入的高血压少数族裔患者中，药物依从性测量方法被证明是可靠的，具有良好的同时效度和预测效度，并且在门诊环境中对其他患者群体可能起到筛查工具的作用。
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