To evaluate, among hypertensive patients, a brief adherence self-report questionnaire (ASRQ), using electronic monitors (medical event monitoring system, MEMS) as the gold standard comparator.
Study Design and Setting
A total of 239 patients with hypertension in five general practices in Bristol, UK completed the ASRQ before and at the end of the 4-week study period. Patients were asked to choose one of six descriptions (from level 1=perfect adherence to level 6=nonadherence) to express their medication taking. The main outcome measure was “timing adherence” (correct interdose intervals) as measured through electronic monitors.
Most patients (89%) stated perfect or nearly perfect adherence, and data from the electronic monitors showed a mean timing adherence of 88.3% (n=216). Using the cutoff of those who reported ASRQ levels 1 and 2 (all tablets taken but not always at the same time of day), a high percentage of those with comparatively high adherence according to MEMS were correctly identified (specificity, 90–93%; negative predictive value, 66–96%). However, sensitivity (detection of true nonadherers) and positive predictive value were poor to moderate (14–42% and 22–66%, respectively).
The questionnaire could be a useful aid to facilitate the difficult differentiation between nonadherence and nonresponse to prescribed antihypertensive medication.
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Published online: August 24, 2007
Accepted: April 23, 2007
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