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Published on: August 1, 2019
Inconclusiveness of psychometric testing of medication adherence questionnaires
Isabelle Arnet1, Christiane Eickhoff2, Laura J Sahm3
1Pharmaceutical Care, Pharmaceutical Sciences, University of Basel, Basel, Switzerland. isabelle.arnet@unibas.ch.
Purpose:
To propose a paradigm change for the validation procedures of medication adherence questionnaires.
Methods:
A total of 121 validation procedures of unique questionnaires for medication adherence were analyzed.
Results:
"Construct validity" and "internal consistency" were most often assessed, and test results varied largely. A more in-depth analysis indicated that the assessment of medication non-adherence included distinct but related constructs, such as the extent to which doses are missed, and the attempt to identify different facets of medication-taking behavior. Consequently, each construct requires a different measurement approach with different psychometric tests for establishing its validity and reliability.
Conclusion:
Results show that assessing the validity and reliability of adherence questionnaires with standard procedures including statistical tests is inconclusive. Refinement of the constructs of non-adherence is needed in pharmacy and medical practice. We suggest a distinction between the (i) extent of missed doses over the past 2 weeks, (ii) modifiable reasons for non-adherence behavior, and (iii) unmodifiable factors of non-adherence. Validation procedures and corresponding statistical methods should be selected according to the specific single constructs.
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