Patient‐reported outcome instruments that evaluate adherence behaviours in adults with asthma: a systematic review of measurement properties. (26th June 2018)

• Record Type: Journal Article
• Authors: Gagné, Myriam; Boulet, Louis‐Philippe; Pérez, Norma; Moisan, Jocelyne
• Is Part Of: British journal of clinical pharmacology. Volume 84:Number 9(2018)
• Page Start: 1928
• Page End: 1940
• Publication Date: 2018-06-26
• Subjects: adherence -- adults -- asthma -- COSMIN -- measurement properties -- patient‐reported outcome instrument -- systematic review; Pharmacology -- Periodicals; Drugs -- Periodicals; 615.1
• DOI: 10.1111/bcp.13623
• Languages: English
• ISSNs: 0306-5251

Abstract

Abstract : Aim: The aim of the present study was to identify systematically the measurement properties of patient‐reported outcome instruments (PROs) that evaluate adherence to inhaled maintenance medication in adults with asthma. Methods: We conducted a systematic review of six databases. Two reviewers independently included studies on the measurement properties of PROs that evaluated adherence in asthmatic participants aged ≥18 years. Based on the COnsensus‐based Standards for the selection of health Measurement INstruments (COSMIN), the reviewers: (i) extracted data on internal consistency, reliability, measurement error, content validity, structural validity, hypotheses testing, cross‐cultural validity, criterion validity and responsiveness; (ii) assessed the methodological quality of the included studies; (iii) assessed the quality of the measurement properties (positive or negative); and (iv) summarized the level of evidence (limited, moderate or strong). Results: We screened 6068 records and included 15 studies (14 PROs). No studies evaluated measurement error or responsiveness. Based on methodological and measurement property quality assessments, we found limited positive evidence of: (i) internal consistency of the Adherence Questionnaire, Refined Medication Adherence Reason (MAR) scale, Medication Adherence Report Scale for Asthma (MARS‐A) and Test of the Adherence to Inhalers (TAI); (ii) reliability of the TAI; and (iii) structural validity of the adherence questionnaire, MAR scale, MARS‐A and TAI. We also found limited negative evidence of: (i) hypotheses testing of the Adherence Questionnaire; (ii) reliability of the MARS‐A; and (iii) criterion validity of the MARS‐A and TAI. Conclusions: Our results highlighted the need to conduct further high‐quality studies to evaluate the reliability, validity and responsiveness of the available PROs.