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Adherence analysis using visual analog scale versus claims-based estimation.

David P Nau1, Douglas T Steinke, L Keoki Williams

  • 1College of Pharmacy, University of Kentucky, Lexington, KY 40536, USA. dnau2@email.uky.edu

The Annals of Pharmacotherapy
|October 11, 2007
PubMed
Summary
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Visual analog scales (VAS) for medication adherence show moderate agreement with claims data. While most patients were classified similarly, direct comparisons between VAS and claims-based studies may be limited.

Area of Science:

  • Pharmacoeconomics
  • Health outcomes research
  • Patient-reported outcomes

Background:

  • Visual analog scales (VAS) are widely used in outcomes research.
  • Evidence for the validity of VAS in measuring medication adherence is limited.

Purpose of the Study:

  • To assess the concordance between a VAS self-report of medication adherence and claims-based adherence measures.
  • To evaluate the validity of VAS as a tool for measuring medication adherence.

Main Methods:

  • A mail survey assessed medication adherence using VAS (0-100%) in patients with diabetes.
  • Prescription claims data provided a continuous measure of medication gaps (CMG), reverse-coded (0-100%).
  • Pearson correlation and kappa coefficient were used to compare continuous and dichotomous (adherence cutoff at 80%) VAS and CMG measures.

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Main Results:

  • VAS and CMG showed moderate correlations for oral diabetes drugs (r=0.22) and lipid-modifying drugs (r=0.26).
  • Concordance for dichotomous adherence classifications was moderate (kappa=0.13 for diabetes drugs, kappa=0.19 for lipid drugs).
  • Mean VAS scores were higher than CMG scores for both drug types.

Conclusions:

  • VAS self-reports demonstrate moderate concordance with medication adherence estimates derived from drug benefit claims.
  • The observed concordance suggests potential limitations for direct comparisons between studies utilizing VAS versus claims-based adherence data.