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Development and validation of a self-report measure of practical barriers to medication adherence: The medication
Amy Hai Yan Chan1, Marcia Vervloet2, Helen Lycett3
1School of Pharmacy, University of Auckland; Centre of Behavioural Medicine, School of Pharmacy, University College London, UK.
Aim:
This study reports the development and validation of a new self-report measure, the Medication Practical barriers to Adherence Questionnaire (MPRAQ), which assesses practical barriers to medication adherence.
Methods:
The MPRAQ comprises 15 statements describing practical barriers. Responses are scored on a 5-point Likert scale; higher scores indicate more practical barriers. Initial face validity was evaluated by cognitive testing with patients from a diabetes support group. Following refinement, internal reliability and construct validity were assessed in two samples: patients recruited via Amazon mTurk and the Nivel Dutch Healthcare Consumer Panel (COPA). Respondents completed the Beliefs about Medicines Questionnaire (BMQ-General and BMQ-Specific), and the Medication Adherence Report Scale (MARS-5). The mTurk sample also completed the Perceived Sensitivity to Medicines questionnaire (PSM) and repeated the MPRAQ 2 weeks later to assess test-retest reliability.
Results:
Face validity was evaluated in 15 patients (46% female; mean (SD) age 64 (12) years). A total of 184 mTurk participants completed the questionnaire (in English) and 334 in COPA (in Dutch). Internal reliability was acceptable (mTurk α = 0.89; COPA α = 0.94). Construct validity was confirmed, with significant correlation between the MPRAQ and BMQ-Specific Concerns (mTurk r = 0.546, P < .0001; COPA r = 0.370, P < .0001), BMQ-General Harm (mTurk r = 0.504, P < 0.0001; COPA r = 0.219, P < .0001), BMQ-General Overuse (mTurk r = 0.324, P < .0001; COPA r = 0.109, P = .047) and PSM (mTurk only r = 0.463, P < .0001), and a negative correlation with MARS-5 (mTurk r = -0.450, P < .0001; COPA r = -0.260, P < .0001). MPRAQ did not correlate with BMQ-Specific Necessity or BMQ-General Benefit. Correlation between MPRAQ baseline and 2-week follow-up scores confirmed test-retest reliability (r = 0.745, P < .0001; n = 52).
Conclusion:
MPRAQ is a reliable and valid self-report measure of practical adherence barriers.
Insights
This study developed the Medication Practical barriers to Adherence Questionnaire (MPRAQ) to measure practical barriers to medication adherence. The MPRAQ is a reliable and valid tool for assessing these barriers.
Area of Science:
- Health Sciences
- Psychometrics
- Patient Adherence
Background:
- Medication adherence is crucial for treatment effectiveness.
- Practical barriers significantly impede patients' ability to follow medication regimens.
- Existing measures may not fully capture the spectrum of practical adherence challenges.
Purpose of the Study:
- To develop and validate a new self-report questionnaire, the Medication Practical barriers to Adherence Questionnaire (MPRAQ).
- To assess practical barriers encountered by patients in adhering to their medications.
Main Methods:
- Developed the 15-item MPRAQ with a 5-point Likert scale.
- Evaluated face validity through cognitive testing with diabetes patients.
- Assessed internal reliability, construct validity, and test-retest reliability in two large online samples (mTurk and COPA).
- Utilized established questionnaires including BMQ, MARS-5, and PSM for validation.
Main Results:
- The MPRAQ demonstrated acceptable to excellent internal reliability (Cronbach's alpha 0.89–0.94).
- Construct validity was confirmed through significant correlations with related measures (BMQ, MARS-5, PSM).
- Test-retest reliability was confirmed with a strong correlation (r=0.745).
Conclusions:
- The MPRAQ is a psychometrically sound and validated instrument.
- It effectively measures practical barriers to medication adherence.
- The MPRAQ can be a valuable tool for clinicians and researchers.
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