Charach Alice, Gajaria Amy, Skyba Anna, Chen Shirley
Research Institute, The Hospital for Sick Children, Toronto, ON.
J Can Acad Child Adolesc Psychiatry. 2008 Aug;17(3):131-6.
This study evaluates the validity, inter-rater reliability, and stability over 3 months of a semi-structured telephone interview measuring adherence to stimulant treatment, the Stimulant Adherence Measure, against the Medication Event Monitoring System (MEMS).
Clinic-referred children (N=22, age 11.85 +/- 2.1 yrs) using psychostimulants for DSM-IV attention-deficit/hyperactivity disorder (ADHD) were eligible. Families used a MEMS device for the primary stimulant medication. Children and parents participated in a semi-structured telephone interview, the Stimulant Adherence Measure, for 3 consecutive months. Parent reports for previous 7 days and 28 days and child report for previous 7 days of medication use were compared to MEMS report. Inter-rater reliability and interview order were also examined.
Nineteen children and parents completed (86%). Agreement between MEMS and parent report for previous 7 days at months 1, 2 and 3 (ICC=0.829, p<0.001; ICC=0.663, p<0.05; ICC=0.878, p<0.001 respectively) and for 28 days at months 1, 2 and 3 (ICC=0.793, p<0.001; ICC=0.907, p< 0.001; ICC=0.806, p<0.001 respectively) was good to excellent. Agreement between MEMS and child report for 7 days at months 1, 2 and 3 (ICC=0.773, p<0.001, ICC=0.542, p<0.05, ICC=0.606, p<0.05 respectively) was good. Inter-rater reliability was excellent (ICC=0.956, p<0.001). There was no interview order effect for parents (F=1.771, p>0.05) or children (F=1.621, p>0.05).
The Stimulant Adherence Measure provides a valid and reliable method for determining stimulant medication use by children with ADHD.
本研究评估一种用于测量兴奋剂治疗依从性的半结构化电话访谈工具——兴奋剂依从性测量法（Stimulant Adherence Measure）相对于药物事件监测系统（MEMS）的有效性、评分者间信度以及3个月期间的稳定性。
符合条件的是因DSM-IV注意力缺陷多动障碍（ADHD）而使用精神兴奋剂的临床转诊儿童（N = 22，年龄11.85±2.1岁）。家庭对主要的兴奋剂药物使用MEMS设备。儿童和家长连续3个月参与半结构化电话访谈——兴奋剂依从性测量法。将家长报告的前7天和28天以及儿童报告的前7天用药情况与MEMS报告进行比较。同时还检查了评分者间信度和访谈顺序。
19名儿童和家长完成了研究（86%）。MEMS与家长报告在第1、2和3个月前7天的一致性（ICC = 0.829，p < 0.001；ICC = 0.663，p < 0.05；ICC = 0.878，p < 0.001）以及在第1、2和3个月前28天的一致性（ICC = 0.793，p < 0.001；ICC = 0.907，p < 0.001；ICC = 0.806，p < 0.001）均良好至优秀。MEMS与儿童报告在第1、2和3个月7天的一致性（ICC = 0.773，p < 0.001，ICC = 0.542，p < 0.05，ICC = 0.606，p < 0.05）良好。评分者间信度优秀（ICC = 0.956，p < 0.001）。家长（F = 1.771，p > 0.05）和儿童（F = 1.621，p > 0.05）均不存在访谈顺序效应。
兴奋剂依从性测量法为确定ADHD儿童的兴奋剂药物使用情况提供了一种有效且可靠的方法。
