Validity of medication adherence self-reports in adults with type 2 diabetes

Jeffrey S. Gonzalez, Havah E. Schneider, Deborah J. Wexler, Christina Psaros, Linda M. Delahanty, Enrico Cagliero, Steven Safren

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

OBJECTIVE-To assess the validity of self-report measures of diabetes medication adherence and evaluate the effect of depression on the validity of these reports. RESEARCH DESIGN ANDMETHODS-Adults with type 2 diabetes, treated with oral medications, completed a set of medication adherence self-reports that varied response scales and time frames, were administered structured clinical interviews for depression, and provided blood samples for HbA1c as part of a screening for an intervention study. A subsample of participants with HbA1c ≥7.0% and clinically significant depression received Medication Event Monitoring System (MEMS) bottle caps to record adherence. Analyses examined relationships between adherence measures and HbA1c and, in the subsample, MEMS. Moderated linear regression evaluated whether depression severity modified relationships with HbA1c. RESULTS-Participant (n = 170, 57% men, 81% white, mean HbA1c 8.3% [SD, 1.7]) adherence self-reports were significantly (r =20.18 to20.28; P1c. In the subsample (n = 88), all self-reports were significantly (r = 0.35 to 0.55; P ≤ 0.001) associated with MEMS-measured adherence. Depression significantly moderated the relationship between three of six self-reports and HbA1c; at high levels of depression, associations with HbA1c became nonsignificant. CONCLUSIONS-Results support the validity of easily administered self-reports for diabetes medication adherence. One-month, percentage-based ratings of adherence had the strongest associations with MEMS and HbA1c; those requiring the report of missed doses had weaker associations. One-week self-ratings and measures that require respondents to record the number of missed doses appear to be vulnerable to bias from depression severity.

Original languageEnglish (US)
Pages (from-to)831-837
Number of pages7
JournalDiabetes Care
Volume36
Issue number4
DOIs
StatePublished - Apr 2013
Externally publishedYes

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Medication Adherence
Self Report
Type 2 Diabetes Mellitus
Depression
Reproducibility of Results
Linear Models
Interviews

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Gonzalez, J. S., Schneider, H. E., Wexler, D. J., Psaros, C., Delahanty, L. M., Cagliero, E., & Safren, S. (2013). Validity of medication adherence self-reports in adults with type 2 diabetes. Diabetes Care, 36(4), 831-837. https://doi.org/10.2337/dc12-0410

Validity of medication adherence self-reports in adults with type 2 diabetes. / Gonzalez, Jeffrey S.; Schneider, Havah E.; Wexler, Deborah J.; Psaros, Christina; Delahanty, Linda M.; Cagliero, Enrico; Safren, Steven.

In: Diabetes Care, Vol. 36, No. 4, 04.2013, p. 831-837.

Research output: Contribution to journalArticle

Gonzalez, JS, Schneider, HE, Wexler, DJ, Psaros, C, Delahanty, LM, Cagliero, E & Safren, S 2013, 'Validity of medication adherence self-reports in adults with type 2 diabetes', Diabetes Care, vol. 36, no. 4, pp. 831-837. https://doi.org/10.2337/dc12-0410
Gonzalez JS, Schneider HE, Wexler DJ, Psaros C, Delahanty LM, Cagliero E et al. Validity of medication adherence self-reports in adults with type 2 diabetes. Diabetes Care. 2013 Apr;36(4):831-837. https://doi.org/10.2337/dc12-0410
Gonzalez, Jeffrey S. ; Schneider, Havah E. ; Wexler, Deborah J. ; Psaros, Christina ; Delahanty, Linda M. ; Cagliero, Enrico ; Safren, Steven. / Validity of medication adherence self-reports in adults with type 2 diabetes. In: Diabetes Care. 2013 ; Vol. 36, No. 4. pp. 831-837.
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