Institute of Nursing Science, Department of Public Health, University of Basel, Switzerland.
Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Transplantation. 2023 Aug 1;107(8):1795-1809. doi: 10.1097/TP.0000000000004574. Epub 2023 Mar 23.
Nonadherence to immunosuppressives, a risk factor for poor posttransplant outcomes, can be assessed by self-report using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS). Available in written and interview versions, and previously validated on content, the BAASIS is widely used in research and clinical practice. The aim of this study was to investigate its psychometric properties.
Using a literature search and our BAASIS database, this meta-analysis identified completed studies in adult transplant recipients whose data were usable to examine the BAASIS' reliability and 3 validity aspects: (1) relationships with other variables (electronic monitoring, other self-report scales, tacrolimus blood-level variability, collateral report, depressive symptoms, psycho-behavioral constructs, and interventions); (2) response processes; and (3) internal structure. Testing used random-effects logistic regressions.
Our sample included 12 109 graft recipients from 26 studies. Of these 26, a total of 20 provided individual participant data. Evidence of the BAASIS' stability over time supports its reliability. Validity testing of relationships with other variables showed that BAASIS-assessed nonadherence was significantly associated with the selected variables: electronically monitored nonadherence ( P < 0.03), other self- and collaterally-reported nonadherence ( P < 0.001), higher variability in tacrolimus concentrations ( P = 0.02), higher barriers ( P < 0.001), lower self-efficacy ( P < 0.001), lower intention ( P < 0.001), and higher worries ( P = 0.02). Nonadherence also decreased after regimen change interventions ( P = 0.03). Response process evaluation indicated good readability and slightly higher nonadherence with the written version. Structurally, items on taking and timing shared variability.
The BAASIS shows good validity and reliability as a self-report instrument to assess medication nonadherence in transplantation.
免疫抑制剂的不依从是移植后不良结局的一个风险因素，可以通过使用巴塞尔免疫抑制剂药物依从性评估量表（BAASIS）进行自我报告来评估。BAASIS 有书面和访谈两种版本，其内容已经过验证，在研究和临床实践中得到了广泛应用。本研究旨在探讨其心理测量学特性。
通过文献检索和我们的 BAASIS 数据库，这项荟萃分析确定了在成年移植受者中完成的研究，这些研究的数据可用于检查 BAASIS 的可靠性和 3 个有效性方面：（1）与其他变量（电子监测、其他自我报告量表、他克莫司血药浓度变异性、间接报告、抑郁症状、心理行为结构和干预措施）的关系；（2）反应过程；（3）内部结构。测试使用随机效应逻辑回归。
我们的样本包括来自 26 项研究的 12109 名移植受者。在这 26 项研究中，共有 20 项提供了个体参与者数据。BAASIS 随时间稳定的证据支持其可靠性。与其他变量关系的有效性测试表明，BAASIS 评估的不依从与所选变量显著相关：电子监测不依从（P<0.03），其他自我和间接报告的不依从（P<0.001），他克莫司浓度变异性更高（P=0.02），障碍更高（P<0.001），自我效能感更低（P<0.001），意图更低（P<0.001），担忧更多（P=0.02）。方案改变干预后不依从性也降低（P=0.03）。反应过程评估表明书面版本具有良好的可读性，略微更高的不依从性。结构上，服用和时间安排的项目共享可变性。
BAASIS 作为一种评估移植后药物不依从性的自我报告工具，具有良好的有效性和可靠性。
