Abstract
Objectives
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.
Results
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).
Conclusion
The questionnaire could be a useful aid to facilitate the difficult differentiation
between nonadherence and nonresponse to prescribed antihypertensive medication.
Keywords
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Article info
Publication history
Published online: August 24, 2007
Accepted:
April 23,
2007
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
