Dunbar-Jacob Jacqueline, Sereika Susan M, Houze Martin, Luyster Faith S, Callan Judith A
University of Pittsburgh–School of Nursing, 3500 Victoria Street Pittsburgh, PA 15261, USA.
West J Nurs Res. 2012 Aug;34(5):578-97. doi: 10.1177/0193945912439251. Epub 2012 Mar 21.
This study examined the concordance between multiple measures of adherence, as well as sensitivity to detection of poor adherers, specificity, and predictive validity using a daily cholesterol-lowering regimen. Participants (N = 180) aged 24 to 60 years participated in an adherence ancillary study in a clinical trial. Males constituted 53.9% of this well-educated, community sample. Data on adherence were collected over a 6-month period, using electronic monitoring, self-report, specific recall, and pill counts. Electronically monitored (odds ratio [OR] = 5.348) and Shea self-report (OR = 2.678) predicted cholesterol lowering. Days (78.9%) and intervals (84.2%) adherent and the Shea (73.7%) were sensitive to the detection of poor adherers. Moderate associations were found between measures of the same type. Low correlations were found otherwise. The electronic monitor was the most accurate and informative measure. The Shea self-report was the most accurate brief, global estimate of adherence. Other measures were not associated with clinical outcome or sensitive to poor adherence.
本研究使用每日降胆固醇方案，考察了多种依从性测量方法之间的一致性，以及对依从性差者的检测敏感性、特异性和预测效度。年龄在24至60岁之间的参与者（N = 180）参加了一项临床试验中的依从性辅助研究。在这个受过良好教育的社区样本中，男性占53.9%。使用电子监测、自我报告、特定回忆和药丸计数等方法，在6个月的时间里收集依从性数据。电子监测（优势比[OR]=5.348）和谢伊自我报告（OR = 2.678）可预测胆固醇降低情况。依从天数（78.9%）、依从间隔（84.2%）以及谢伊自我报告（73.7%）对依从性差者的检测较为敏感。同一类型的测量方法之间存在中度关联。其他情况下相关性较低。电子监测是最准确且信息丰富的测量方法。谢伊自我报告是对依从性最准确的简短整体估计。其他测量方法与临床结果无关，对依从性差也不敏感。
