de Bock Elodie, Dolgin Kevin, Kombargi Léa, Arnould Benoit, Vilcot Tanguy, Hubert Guillaume, Laporte Marie-Eve, Nabec Lydiane, Reach Gérard
Patient Centred Outcomes, ICON plc, Lyon, France.
Observia, Paris, France.
Patient Prefer Adherence. 2022 May 12;16:1213-1231. doi: 10.2147/PPA.S354705. eCollection 2022.
The SPUR (Social, Psychological, Usage and Rational) Adherence Profiling Tool is a recently developed adaptive instrument for assessing key patient-level drivers for non-adherence. This study describes the SPUR questionnaire's finalization and psychometric evaluation.
Data were collected through an online survey among patients with type 2 diabetes included by general practitioners and diabetologists in France. The survey included four questionnaires, SPUR and three validated adherence measures: BMQ, MARS and ACCEPT. Item-level analysis and a partial credit model (PCM) were performed to refine the response option coding of SPUR items. The final item selection of SPUR was defined using a PCM and a principal component analysis (PCA). Construct validity, concurrent validity and known-groups validity were assessed on the final SPUR questionnaire.
A total of 245 patients (55% men, mean age of 63 years) completed the survey remotely and were included in this analysis. Refining response option coding allowed a better discrimination of patients on the latent trait. After item selection, a short, an intermediate, and a long form composed the final SPUR questionnaire. The short form will be used to screen patients for risk and then the other forms will allow the collection of further information to refine the risk assessment and decide the best levers for action. Results obtained were supportive of the construct validity of the forms. Their concurrent validity was demonstrated: moderate to high significant correlations were obtained with BMQ, MARS and ACCEPT scores. Their known-groups validity were shown with a logical pattern of higher scores obtained for patients considered non-adherent and significant differences between the scores obtained for patients considered adherent versus non-adherent.
SPUR is a valid tool to evaluate the risk of non-adherence of patients, allowing effective intervention by providing insights into the respective individual reasons for lack of adherence.
SPUR（社会、心理、使用情况和合理性）依从性剖析工具是一种最近开发的适应性工具，用于评估导致不依从的关键患者层面因素。本研究描述了SPUR问卷的定稿及心理测量学评估。
通过在线调查收集法国全科医生和糖尿病专家纳入的2型糖尿病患者的数据。该调查包括四份问卷，即SPUR以及三项经过验证的依从性测量工具：BMQ、MARS和ACCEPT。进行了项目层面分析和部分计分模型（PCM）以完善SPUR项目的回答选项编码。使用PCM和主成分分析（PCA）确定SPUR的最终项目选择。对最终的SPUR问卷进行了结构效度、同时效度和已知群组效度评估。
共有245名患者（55%为男性，平均年龄63岁）远程完成了调查并纳入本分析。完善回答选项编码能够更好地区分潜在特征上的患者。项目选择后，最终的SPUR问卷由简短版、中间版和长版组成。简短版将用于筛查患者的风险，然后其他版本将用于收集更多信息以完善风险评估并确定最佳行动策略。所获结果支持各版本的结构效度。其同时效度得到了证明：与BMQ、MARS和ACCEPT评分呈中度至高度显著相关。其已知群组效度通过以下方式得以体现：被认为不依从的患者得分更高，且被认为依从与不依从的患者得分存在显著差异，呈现出合理的模式。
SPUR是评估患者不依从风险的有效工具，通过深入了解个体不依从的各自原因，可实现有效干预。
