Performance of two questionnaires to measure treatment adherence in patients with Type-2 diabetes

Prado-Aguilar, Carlos A.; Martínez, Yolanda V.; Segovia-Bernal, Yolanda; Reyes-Martínez, Rosendo; Arias-Ulloa, Raul
January 2009
BMC Public Health;2009, Vol. 9 Issue 1, p38
Academic Journal
Background: Most valid methods to measure treatment adherence require time and resources, and they are not easily applied in highly demanding Primary Health Care Clinics (PHCC). The objective of this study was to determine sensitivity, specificity, predictive values, likelihood ratios, and post-test probabilities of two novel questionnaires as proxy measurements of treatment adherence in Type-2 diabetic patients. Methods: Two questionnaires were developed by a group of experts to identify the patient's medical prescription knowledge (knowledge) and their attitudes toward treatment adherence (attitudes) as proxy measurements of adherence. The questionnaires were completed by patients receiving care in PHCC pertaining to the Mexican Institute of Social Security in Aguascalientes (Mexico). Pill count was used as gold standard. Participants were selected randomly, and their oral hypoglycemic prescriptions were studied. The main outcome measures for each questionnaire were sensitivity, specificity, predictive values, likelihood ratios, and post-test probabilities, all as an independent questionnaire test and in a serial analysis. Results: Adherence prevalence was 27.0% using pill count. Knowledge questionnaire showed the highest sensitivity (68.1%) and negative predictive value (82.2%), the lowest negative likelihood ratio (0.58) and post-test probability for a negative result (0.16). Serial analysis showed the highest specificity (77.4%) and positive predictive value (40.1%) as well as the highest positive likelihood ratio (1.8) and post-test probability for a positive result (0.39). Conclusion: Medical Prescription Knowledge questionnaire showed the best performance as proxy measurement to identify non-adherence in type 2 diabetic patients regarding negative predictive value, negative likelihood ratio, and post-test probability for a negative result. However, Medical Prescription Knowledge questionnaire performance may change in contexts with higher adherence prevalence. Therefore, more research is needed before using this method in other contexts.


Related Articles

  • Canagliflozin - Beginning of the journey. Pandey, Sunil Kumar; Dass, Deepanjana // Journal of Pharmacy & Bioallied Sciences;Apr-Jun2014, Vol. 6 Issue 2, p132 

    A letter to the editor is presented in response to the article on the approval of Canagliflozin as treatment for type two diabetes mellitus.

  • National Diabetes Month, 2013.  // Federal Register (National Archives & Records Service, Office of;11/5/2013, Vol. 78 Issue 214, p66613 

    The article presents presidential documents on National Diabetes Month, 2013. It states that this month, U.S. administration combating this chronic, life-threatening illness by standing with those living with diabetes. It further mentions that administration supporting Americans living with...

  • Actos. Trecroci, Daniel // Diabetes Health;Oct2005, Vol. 14 Issue 10, p25 

    Evaluates oral agent Actos for type 2 diabetes patients. Mechanism of action; Effect on blood glucose; Instruction in taking the agent.

  • Supplement support for glucose stability.  // Alive: Canada's Natural Health & Wellness Magazine;Nov2008, Issue 313, p168 

    The article lists several nutritional supplements that can help regulate blood sugar levels, including chromium, conjugated linoleic acid and Chia seed.

  • Nurse-Community Health Worker Team Improves Diabetes Care in American Samoa. DEPUE, JUDITH D.; DUNSIGER, SHIRA; SEIDEN, ANDREW D.; BLUME, JEFFREY; ROSEN, ROCHELLE K.; GOLDSTEIN, MICHAEL G.; NU'USOLIA, OFEIRA; TUITELE, JOHN; MCGARVEY, STEPHEN T. // Diabetes Care;Jul2013, Vol. 36 Issue 7, p1947 

    OBJECTIVE--To evaluate the effectiveness of a culturally adapted, primary care-based nurse-community health worker (CHW) team intervention to support diabetes self-management on diabetes control and other biologic measures. RESEARCH DESIGN AND METHODS--Two hundred sixty-eight Samoan participants...

  • Single Insulin-Specific CD8+ T Cells Show Characteristic Gene Expression Profiles in Human Type 1 Diabetes. Luce, Sandrine; Lemonnier, François; Briand, Jean-Paul; Coste, Joel; Lahlou, Najiba; Muller, Sylviane; Larger, Etienne; Rocha, Benedita; Mallone, Roberto; Boitard, Christian // Diabetes;Dec2011, Vol. 60 Issue 12, p3289 

    OBJECTIVE--Both the early steps and the high recurrence of autoimmunity once the disease is established are unexplained in human type 1 diabetes. Because CD8+ T cells are central and insulin is a key autoantigen in the disease process, our objective was to characterize HLA class I--restricted...

  • COMPLICATIONS OF DIABETES -- NEPHROPATHY.  // Current Medical Literature: Diabetes;2004, Vol. 21 Issue 1, p15 

    Presents citations and clinician's notes about complications of diabetic nephropathy. Sustained effect of intensive treatment of type 1 diabetes mellitus on development and progression of diabetic nephropathy; Association of diabetic nephropathy with low-grade inflammation in type 1 diabetic...

  • Improving Efficacy of Diabetes Management Using Treatment Algorithms in a Mainly Hispanic Population. Fanning, Etta L.; Selwyn, Beatrice J.; Larme, Anne C.; DeFronzo, Ralph A. // Diabetes Care;Jul2004, Vol. 27 Issue 7, p1638 

    OBJECTIVE — To compare clinical outcomes obtained using treatment algorithms versus standard "usual care" to treat patients with type 2 diabetes in a community setting. RESEARCH DESIGN AND METHODS — An observational group comparison was implemented in three community-based clinics...

  • Empowerment and Self-Management of Diabetes. Funnell, Martha M.; Anderson, Robert M. // Clinical Diabetes;Summer2004, Vol. 22 Issue 3, p123 

    Discusses the proper management of diabetes to achieve optimal outcomes and prevent further complications. Models of care and education; Overview of behavior-change protocol; Practice design for empowerment and self-management; Information on challenges faced by health professionals in shifting...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics