伊朗老年中风患者中 5 项药物依从性报告量表的验证。
Validation of the 5-Item Medication Adherence Report Scale in Older Stroke Patients in Iran.
机构信息
Chung-Ying Lin, PhD Assistant Professor, Faculty of Health and Social Sciences, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom. Huang-tz Ou, MD, PhD Associate Professor, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine; Department of Pharmacy, College of Medicine; and Department of Pharmacy, National Cheng Kung University, Tainan, Taiwan. Mehdi Nikoobakht, MD Assistant Professor, Department of Neurosurgery, Iran University of Medical Sciences, Tehran. Anders Broström, PhD Professor, Department of Nursing, School of Health and Welfare, Jönköping University, Sweden. Kristofer Årestedt, PhD Professor, Faculty of Health and Life Sciences, Linnaeus University; and Department of Research, Kalmar County Hospital, Kalmar, Sweden. Amir H. Pakpour, PhD Associate Professor, Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Iran; and Department of Nursing, School of Health and Welfare, Jönköping University, Sweden.
出版信息
J Cardiovasc Nurs. 2018 Nov/Dec;33(6):536-543. doi: 10.1097/JCN.0000000000000488.
BACKGROUND
There is a lack of feasible and validated measures to self-assess medication adherence for older patients with stroke. In addition, the potential determinants of medication adherence for older patients with stroke remain unclear.
OBJECTIVES
The aims of this study were to (1) examine the psychometric properties of a 5-item questionnaire on medication adherence, specifically the 5-item Medication Adherence Report Scale (MARS-5), and (2) explore the determinants of medication adherence.
METHODS
Stroke patients older than 65 years (N = 523) filled out the MARS-5 and the Hospital Anxiety and Depression Scale. The medication possession rate (MPR) was calculated to measure the objective medication adherence. Several clinical characteristics (stroke types, blood pressure, comorbidity, HbA1c, quantity of prescribed drugs, fasting blood glucose, and total cholesterol) and background information were collected. We used Rasch analysis with a differential item functioning test to examine psychometric properties.
RESULTS
All 5 items in the MARS-5 fit in the same construct (ie, medication adherence), no differential item functioning items were displayed in the MARS-5 across gender, and the MARS-5 total score was strongly correlated with the MPR (r = 0.7). Multiple regression models showed that the MARS-5 and the MPR shared several similar determinants. In addition, the variance of the MARS-5 (R = 0.567) was more than that of the MPR (R = 0.300).
CONCLUSIONS
The MARS-5 is a feasible and valid self-assessed medication adherence for older patients with stroke. In addition, several determinants were found to be related to medication adherence for older patients with stroke. Healthcare providers may want to take heed of these determinants to improve medication adherence for this population.
背景
对于老年脑卒中患者，缺乏可行且经过验证的评估药物依从性的方法。此外，老年脑卒中患者药物依从性的潜在决定因素尚不清楚。
目的
本研究旨在（1）检验 5 项药物依从性问卷（即 5 项药物依从性报告量表[MARS-5]）的心理测量学特性，（2）探讨药物依从性的决定因素。
方法
年龄＞65 岁的脑卒中患者（N=523）填写 MARS-5 和医院焦虑抑郁量表。计算药物持有率（MPR）以衡量客观药物依从性。收集了一些临床特征（脑卒中类型、血压、合并症、HbA1c、开处药物数量、空腹血糖和总胆固醇）和背景信息。我们使用 Rasch 分析和差异项目功能测试来检验心理测量学特性。
结果
MARS-5 的 5 个项目都符合同一结构（即药物依从性），MARS-5 中没有性别差异的项目，MARS-5 总分与 MPR 呈强相关（r=0.7）。多元回归模型显示，MARS-5 和 MPR 有几个共同的决定因素。此外，MARS-5 的方差（R=0.567）大于 MPR 的方差（R=0.300）。
结论
MARS-5 是一种适用于老年脑卒中患者的可行且有效的自评药物依从性量表。此外，还发现了一些与老年脑卒中患者药物依从性相关的决定因素。医疗保健提供者可能需要注意这些决定因素，以提高该人群的药物依从性。
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