Validity Of The Self-Reported Domains Of Subjective Extent Of Nonadherence (DOSE-Nonadherence) Scale In Comparison With Electronically Monitored Adherence To Cardiovascular Medications
Validity Of The Self-Reported Domains Of Subjective Extent Of Nonadherence (DOSE-Nonadherence) Scale In Comparison With Electronically Monitored Adherence To Cardiovascular Medications
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Talea Cornelius,1 Corrine I Voils,2,3 Redeana C Umland,1 Ian M Kronish1 1Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, USA; 2William S Middleton Veterans Memorial Hospital, Madison, WI 53705, USA; 3Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53792, USACorrespondence: Talea CorneliusCenter for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 West 168th Street PH9-319, New York, NY 10032, USATel +1212-304-5215Email [email protected]: Self-report measures are important tools for assessing adherence to medication.Many of these scales, however, combine the extent of and reasons for nonadherence in one instrument, and have limited reliability and validity.
The present study was the first to assess the convergent validity of the self-reported Domains of Subjective Extent of Nonadherence (DOSE-Nonadherence) scale with electronically measured adherence to a single cardiovascular medication.Methods: English- and Spanish-speaking patients evaluated for acute coronary Soccer - Clothing Mens Tops syndrome (N=165; n=68 and n= 97, respectively) were Fixed Blade Outdoors recruited from an urban academic emergency department.Post-hospital discharge, participants were mailed a medication bottle with an electronic cap (eCAP) that recorded bottle openings.At 1 month, participants completed the 3-item DOSE-Nonadherence scale, which assessed the extent to which patients missed, skipped, or did not take the eCAP-monitored medication over the past 7 days.
Correlations, sensitivity, and specificity were calculated using eCAP-monitored correct dosing adherence over the same 7-day time period as the reference standard.Results: The most commonly assessed medication was aspirin (70.91%).Correlations between self-reported and electronically monitored adherence were low-to-moderate: English-speaking participants (n=68), r=0.
24, p=0.046; Spanish-speaking participants (n=97), r=0.18, p=0.071.
Sensitivity was low (0.47 English, 0.28 Spanish) and specificity was moderate (0.77 English, 0.
88 Spanish).Conclusions: The DOSE-Nonadherence scale was associated with electronically monitored adherence to a single daily cardiovascular medication in English-speaking participants, but had weak diagnostic properties when using electronic adherence as the reference standard.Keywords: medication adherence, self-report, nonadherence, validity, electronic monitoring.