Development of a New Patient-Reported Medication Adherence Instrument: Concerns Influencing Medication Adherence

Area of Science:

• Pharmacology and Patient Adherence Research
• Health Services Research
• Qualitative Research Methods

Background:

• Medication non-adherence is a significant challenge in managing chronic conditions.
• Understanding patient-specific concerns is crucial for improving treatment adherence.
• Existing tools may not fully capture patient-reported reasons for non-adherence.

Purpose of the Study:

• To develop a novel instrument for identifying patients at risk of medication non-adherence.
• To capture patient concerns regarding prescribed treatments.
• To create a tool for use in clinical practice and population health management.

Main Methods:

• A two-stage, multi-year qualitative study.
• Exploration and refinement of concepts related to medication adherence concerns.
• Target populations included patients with atrial fibrillation and osteoarthritis.

Main Results:

• Identified key concerns: side effects, bleeding risk (atrial fibrillation); stomach, kidney, liver issues (osteoarthritis).
• Developed the Concerns Influencing Medication Adherence (CIMA) instrument (16 items).
• CIMA includes core, atrial fibrillation-specific, and osteoarthritis-specific items for electronic use.

Conclusions:

• CIMA is the first instrument incorporating documented patient input for medication adherence, aligning with FDA guidance.
• Patient-reported concerns are vital for content validity and predicting adherence.
• The instrument shows potential for assessing adherence in other chronic diseases beyond atrial fibrillation and osteoarthritis.