Abstract:
BACKGROUND:Less than half of patients with cardiometabolic disease consistently take prescribed medications. While health insurers and some delivery organizations use claims to measure adherence, most clinicians do not have access during routine interactions. Self-reported scales exist, but their practical utility is often limited by length or cost. By contrast, the accuracy of a new 3-item self-reported measure has been demonstrated in individuals with HIV. We evaluated its concordance with claims-based adherence measures in cardiometabolic disease. METHODS:We used data from a recently-completed pragmatic trial of patients with cardiometabolic conditions. After 12 months of follow-up, intervention subjects were mailed a survey with the 3-item measure that queries about medication use in the prior 30 days. Responses were linearly transformed and averaged. Adherence was also measured in claims in month 12 and months 1-12 of the trial using proportion of days covered (PDC) metrics. We compared validation metrics for non-adherence for self-report (average <0.80) compared with claims (PDC <0.80). RESULTS:Of 459 patients returning the survey (response rate: 43.5%), 50.1% were non-adherent in claims in month 12 while 20.9% were non-adherent based on the survey. Specificity of the 3-item metric for non-adherence was high (month 12: 0.83). Sensitivity was relatively poor (month 12: 0.25). Month 12 positive and negative predictive values were 0.59 and 0.52, respectively. CONCLUSIONS:A 3-item self-reported measure has high specificity but poor sensitivity for non-adherence versus claims in cardiometabolic disease. Despite this, the tool could help target those needing adherence support, particularly in the absence of claims data.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Lauffenburger JC,Fontanet CP,Isaac T,Gopalakrishnan C,Sequist TD,Gagne JJ,Jackevicius CA,Fischer MA,Solomon DH,Choudhry NKdoi
10.1016/j.ahj.2020.06.012subject
Has Abstractpub_date
2020-10-01 00:00:00pages
36-43eissn
0002-8703issn
1097-6744pii
S0002-8703(20)30192-7journal_volume
228pub_type
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pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-11-01 00:00:00
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更新日期:2006-04-01 00:00:00
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更新日期:2009-01-01 00:00:00
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