Measures of adherence based on self-report exhibited poor agreement with those based on pharmacy records

To assess the level of agreement between a self-reported measure of adherence with prescribed drug and a measure of adherence based on pharmacy data. During an in-home interview, people aged 65+ were asked to report all prescription drugs they had taken in the preceding month. For each drug, a four-...

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Bibliographic Details
Published in:Journal of clinical epidemiology 2005-09, Vol.58 (9), p.924-933
Main Authors: Guénette, Line, Moisan, Jocelyne, Préville, Michel, Boyer, Richard
Format: Article
Language:English
Subjects:
Age Factors
Aged
Antiretroviral drugs
Biological and medical sciences
Compliance
Cross-Sectional Studies
Drug
Drug Prescriptions
Drug Therapy
Epidemiology
Female
General aspects
HIV
Human immunodeficiency virus
Humans
Male
Medical Records
Medical sciences
Methodology
Pharmacies
Public health. Hygiene
Public health. Hygiene-occupational medicine
Questionnaire
Self-Assessment
Studies
Validity
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Summary:To assess the level of agreement between a self-reported measure of adherence with prescribed drug and a measure of adherence based on pharmacy data. During an in-home interview, people aged 65+ were asked to report all prescription drugs they had taken in the preceding month. For each drug, a four-item questionnaire was used to determine self-reported adherence. In the pharmacy records, each drug that had been filled at least four times was analyzed, and the percentage of days with the drug available was calculated. Two types of adherence were studied: (1) adherence by individual, and (2) adherence by drug. The level of agreement was assessed using kappa (κ) statistics and proportions of agreement. We compared the adherence measures among 189 individuals (880 drugs). Among all, 90 individuals (48%) self-reported adherence, whereas 95 individuals (50%) were adherent according to the records. The level of agreement between these two measures was slight (κ = 0.16 [95% CI: 0.02–0.30]). Individuals self-reported to be adherent for 81% of the drugs, while pharmacy records showed adherence for 83% of them (κ = 0.13 [95% CI: 0.05–0.20]). Self-reported measures of adherence exhibited poor agreement with those based on pharmacy records.
ISSN:0895-4356
1878-5921
DOI:10.1016/j.jclinepi.2005.02.002