Jaclyn K. Schwartz, PhD, OTR/L, FAOTA, is Assistant Professor, Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO;
Katherine Aylmer, OTD, OTR/L, is Occupational Therapist, Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO.
Am J Occup Ther. 2024 May 1;78(3). doi: 10.5014/ajot.2024.050500.
Occupational therapy practitioners use standardized assessments to guide their clinical decision-making, but it is unclear how well performance on standardized assessments translates to performance at home.
To understand the concurrent and predictive validity of patient-reported outcomes and performance-based assessments for monitoring performance at home within the context of medication management and adherence.
Exploratory study.
Participants completed standardized assessments in a lab or at home, which were followed by home-based electronic monitoring of medication adherence.
Sixty community-dwelling adults with hypertension or stroke who independently took antihypertensive medications.
Participants completed the Hill-Bone Medication Adherence Scale, the Hill-Bone Medication Adherence Reasons Scale, the Performance Assessment of Self-Care Skills Medication Management subtask, and the Executive Function Performance Test-Enhanced Medication Management subtest. Then, they used an electronic pill cap to monitor medication adherence at home for 1 month.
Patient-reported outcomes and performance-based assessments in the context of medication management and adherence demonstrated poor concurrent and predictive validity to medication adherence at home.
There is a gap between what people think they will do, what they can do on a standardized assessment, and what they actually do at home. Future research is needed to strengthen concurrent and predictive validity to clinically meaningful outcomes. Plain-Language Summary: Occupational therapy practitioners should use caution when using standardized assessments to try to predict client performance at home. They should also continue to use a battery of assessments, clinical reasoning, and client preferences to guide their decision-making for monitoring performance at home within the context of medication management and adherence.
职业治疗师使用标准化评估来指导他们的临床决策，但尚不清楚标准化评估中的表现与家庭中的表现之间的相关性如何。
了解患者报告的结果和基于表现的评估在药物管理和依从性背景下监测家庭表现的同时效度和预测效度。
探索性研究。
参与者在实验室或家中完成标准化评估，随后对药物依从性进行基于家庭的电子监测。
60 名居住在社区的高血压或中风成年人，他们独立服用降压药物。
参与者完成了 Hill-Bone 药物依从性量表、Hill-Bone 药物依从性原因量表、自理技能药物管理表现评估子任务和执行功能测试-增强药物管理子测试。然后，他们使用电子药瓶盖在家中监测药物依从性 1 个月。
药物管理和依从性背景下的患者报告结果和基于表现的评估与家庭药物依从性的同时效度和预测效度均较差。
人们对自己将要做什么、在标准化评估中能做什么以及实际在家中做什么的看法之间存在差距。未来的研究需要加强与临床有意义的结果的同时效度和预测效度。
