What is a missed dose? Implications for construct validity and patient adherence

The construct 'missed dose' is central to many assessments of medication adherence. However, few studies have investigated how patients or clinicians conceptualize missed doses or the extent of the concordance or discordance between clinicians and patients. To address this gap we conducted semi-structured interviews with 45 sero-positive African American adults taking HAART and 17 of their clinicians. Results reveal large variability in missed dose conceptions among both patients and physicians and significant differences between the two groups. Overall, patients reported a stricter definition of missed dose than did clinicians. Fifty-five percent of patients thought that a pill-taking delay of six hours beyond the prescribed dosing time constituted a missed dose, by comparison, only one physician agreed with this assessment. More than one-third of patients thought that the proper response to a missed dose would be to skip it altogether, but only about 12% of clinicians agreed. These findings have implications for the construct validity of self-report measures of adherence, for patient adherence behaviours based on missed dose conceptions and for patient-physician relationships and communication within the clinical environment

Concordance · Construct validity · Dosing · Family medicine · Medication adherence · Pill · Psychometrics · Adolescent and Pediatric Healthcare · Clinical Psychology · HIV/AIDS Research and Interventions · Medication Adherence and Compliance · Medicine · Nursing · Internal Medicine

• Engaging Opportunities in Urban Revitalization

  Open Access•Sherylyn Briller, Sherylyn H Briller et al.•Annals of Anthropological Practice•2013

  Incluir item

• Assessing Antiretroviral Adherence via Electronic Drug Monitoring and Self-Report

  Open Access•Cynthia Pearson, Cynthia R Pearson et al.•AIDS and Behavior•2006

  Incluir item

• What Time is it? Adherence to Antiretroviral Therapy in Ethiopia

  Open Access•Yordanos M Tiruneh, Ira B Wilson•AIDS and Behavior•2016

  Incluir item

• Intentionality of medication non-adherence among individuals living with HIV/Aids in Hong Kong

  Phoenix K H Mo, Winnie W S Mak•AIDS Care•2009

  Incluir item

• Depressive symptoms and self-reported adherence to medical recommendations to prevent cardiovascular disease

  Open Access•Jessica Berntson, Kendra Ray Stewart et al.•Social Science & Medicine•2015

  Incluir item

• Multiple Validated Measures of Adherence Indicate High Levels of Adherence to Generic HIV Antiretroviral Therapy in a Resource-Limited Setting

  Jessica H Oyugi, Jayne Byakika-Tusiime et al.•JAIDS Journal of Acquired Immune…•2004

  Incluir item

• Responses to a 1 month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome

  John Walsh, John C Walsh et al.•AIDS•2002

  Incluir item

• A prospective study of predictors of adherence to combination antiretroviral medication

  Carol E Golin, Honghu Liu et al.•Journal of General Internal…•2002

  Incluir item

• Self-reported adherence to antiretroviral medications among participants in HIV clinical trials

  Margaret A Chesney, Jeannette R Ickovics et al.•AIDS Care•2000

  Incluir item

• Qualitative and quantitative assessments of Haart adherence of substance-abusing women

  Gail Powell‐cope, G M Powell-Cope et al.•AIDS Care•2003

  Incluir item

• Characteristics of HIV antiretroviral treatments, access and adherence in an ethnically diverse sample of men who have sex with men

  Perry N Halkitis, Jeffrey T Parsons et al.•AIDS Care•2003

  Incluir item

• The process of self-report of impairment in clinical research

  Open Access•Mark Luborsky, Mark R Luborsky•Social Science & Medicine•1995

  Incluir item