Razvoj i validacija upitnika o adherenciji prema uzimanju lijekova

master's thesis

• Title (english): Development and validation of a self-reported medical adherence tool
• Author: Mislav Balen
• Mentor: Maja Ortner Hadžiabdić (mentor)
• Mentor: Iva Bužančić (mentor)
• Committee member: Maja Ortner Hadžiabdić (predsjednik povjerenstva)
• Committee member: Iva Bužančić (član povjerenstva)
• Committee member: Lidija Bach-Rojecky (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Centre for applied pharmacy); Zagreb
• Defense date and country: 2024-09-30, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Unatoč dostupnosti raznih upitnika za mjerenje adherencije prema uzimanju lijekova, učinkovito
identificiranje stupnja neadherncije i njenih uzroka u praksi i dalje predstavlja izazov. Postojećim upitnicima
često nedostaje jednostavnost primjene koja je nužna za upotrebu u kliničkoj praksi. Cilj ovog diplomskog
rada bio je razviti i validirati korsnicima pristupačan upitnik koji zdravstvenim radnicima daje koncizno, a
sveobuhvatno sredstvo za identifikaciju ponašanja vezanih uz adherenciju. Metodologija se sastojala od dvije
faze: upitnik je prvo izrađen korištenjem metode nominalne skupine u kojoj su bili zdravstveni radnici, nakon
čega je uslijedilo presječno istraživanje koje je uključivalo punoljetne stanovnike Hrvatske. Analiza
valjanosti ukazala na prihvatljivu izravnu i sadržajnu valjanost te zadovoljavajuću kriterijsku valjanost, pri
čemu su rezultati „Attitudes towards meDication adHerence self-Reported questionnairE“ (ADHERE-7)
korelirali i sa rezultatima „Medication Adherence Report Scale“ (MARS-5 upitnik) (ϱ = 0.765; p < 0.001) i
sa objektivnom mjerom udjela dana pokrivenih terapijom (engl. proportion of days covered, PDC)
izračunatim pomoću povijesti podizanja lijekova iz kartica pacijenata iz ljekarni (G = 0,586; p = 0,015).
Analiza konstruktne valjanosti otkrila je tri faktora: Neadherenciju uzrokovanu obojnošću, Neadherenciju
uslijed lagode i Praktičnu neadherenciju. Prosječni rezultat ADHERE-7 upitnika je bio 26,27 ± 2,41 (raspon
od 17 do 28). Ovaj robusni proces validacije potvrdio je da je ADHERE-7 upitnik pouzdan instrument za
procjenu adherencije prema uzimanju lijekova, procjenu problema vezanih uz odbojnost, lagodu i praktičnost
te za procjenu namjerne i nenamjerne neadherencije.

Abstract (english)

Despite the availability of various tools for measuring medication adherence, efficiently identifying nonadherence
levels and reasons at the point of care remains challenging. Existing tools often lack the ease of
use needed for practical clinical application. This study aimed to develop and validate a user-friendly tool to
provide healthcare professionals with a concise yet comprehensive means of identifying adherence behaviors.
The methodology consisted of two phases: tool items were first developed using the nominal group technique
with healthcare professionals, followed by a cross-sectional pilot study involving community-dwelling adults
in Croatia. Validation analysis indicated acceptable face and content validity and satisfactory criterion
validity, with Attitudes towards meDication adHErence self-Reported questionnairE (ADHERE-7) scores
correlating with both the self-reported five-item Medication Adherence Report Scale (MARS-5 tool) (ϱ =
0.765; p < 0.001) and an objective measure of the proportion of days covered (PDC) from pharmacy
prescription claims data (G = 0.586; p = 0.015). Construct validity revealed three factors: Aversion, Comfort,
and Practical Non-Adherence, with Cronbach’s alpha values of 0.617 for Aversion and 0.714 for Comfort
Non-Adherence. The mean total score for ADHERE-7 was 26.27 ± 2.41 (range 17 to 28). This robust
validation process confirms the ADHERE-7 tool as a reliable instrument for assessing medication adherence,
addressing aversion, comfort, practical issues, and both intentional and unintentional nonadherence.

• Keywords: adherencija za lijekove; terapijska suradljivost; politerapija; upitnik
• Keywords (english): medication adherence; therapeutic cooperation; polytherapy; questionnaire
• Language: croatian
• URN:NBN: urn:nbn:hr:163:289826
• Study programme: Title: Pharmacy - integrated undergraduate and graduate - university study; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: sveučilišni magistar farmacije (sveučilišni magistar farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2025-01-09 14:13:51