Construct Validity and Factor Structure of Survey-based Assessment of Cost-related Medication Burden
Bibliographic Data
| ID | 9105051 |
|---|---|
| Authors | Mehmet Burcu (0000-0003-4572-0987, corresponding author), G Caleb Alexander (0000-0002-5622-2986, Johns Hopkins University), Xinyi Ng (0000-0002-0736-8276, corresponding author), Donna Harrington (University of Maryland, Baltimore) |
| Year | 2015 |
| Volume | 53 |
| Issue | 2 |
| Pages | 199-206 |
| Publication date | 2015-02-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000286 |
| PMID | 25517070 |
| OpenAlex | W2316734598 |
| Language | EN |
| Citations received | 3 |
| References cited | 36 |
BACKGROUND: Millions of Americans are burdened by out-of-pocket prescription costs. Although many survey measures have been developed to assess this burden, the construct validity and the factor structure of these instruments have not been rigorously assessed. OBJECTIVES: To characterize the factor structure and the construct validity of items assessing cost-related medication burden. METHODS: We applied exploratory factor and confirmatory factor analyses to the 2009 Medicare Current Beneficiary Survey, focusing on 10 items assessing cost-related mediation burden among a nationally representative sample of community-dwelling Medicare beneficiaries. The fit of competing models was compared using several indices. RESULTS: The study population (N=8777) was predominantly aged over 65 years (83.3%), female (54.4%), and white (84.3%). Two distinct factors were present for the medication cost-reduction strategies: (1) cost-related medication nonadherence and (2) drug-shopping behaviors, not directly impacting medication compliance. The two factors were moderately correlated (r=0.55), highlighting the presence of a 2 distinct but related constructs for cost-related medication burden. An item assessing the use of mail or internet pharmacies did not load well on either factor and may not necessarily measure medication-related cost burden. An item assessing reduced spending on basic needs loaded strongly on the same factor with the cost-related medication nonadherence items, suggesting they together may represent extreme compensatory behaviors that may adversely affect health outcomes. CONCLUSIONS: Two distinct constructs were derived from these items examining cost-related medication burden. Although cost-related medication burden is often associated with nonadherence, drug-shopping behaviors that do not directly impact adherence are also important measure of this burden
Confirmatory factor analysis · Construct validity · Environmental health · Exploratory factor analysis · Medical prescription · Medicare Part D · Population · Prescription drug · Psychometrics · Structural equation modeling · Clinical Psychology · Economic and Financial Impacts of Cancer · Medication Adherence and Compliance · Medicine · Nursing · Pharmaceutical Practices and Patient Outcomes
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Cost-related Nonadherence by Medication Type Among Medicare Part D Beneficiaries With Diabetes
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| Unique citing works | 3 |
|---|---|
| Citations per year | 0,3 |
| Citation span | 2016 - 2021 (6) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 3 |