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. 2022 Sep 6;12(9):e058467.
doi: 10.1136/bmjopen-2021-058467.

SPUR: psychometric properties of a patient-reported outcome measure of medication adherence in type 2 diabetes

Joshua Sterling Wells  1 , Aya El Husseini  1 , Sandra Okoh  1 , Ali Jaffar  1 , Claire Neely  2 , Philip Crilly  1 , Kevin Dolgin  3 , Reem Kayyali  4
Affiliations

SPUR: psychometric properties of a patient-reported outcome measure of medication adherence in type 2 diabetes

Joshua Sterling Wells et al. BMJ Open. .

Abstract

Introduction: Poor medication adherence is associated with worsening patient health outcomes and increasing healthcare costs. A holistic tool to assess both medication adherence and drivers of adherence behaviour has yet to be developed. This study aimed to examine SPUR, a multifactorial patient-reported outcome measure of medication adherence in patients living with type 2 diabetes, with a view to develop a suitable model for psychometric analysis.Furthermore, the study aimed to explore the relationship between the SPUR model and socio-clinical factors of medication adherence.

Research design and methods: The study recruited 378 adult patients living with type 2 diabetes from a mix of community and secondary-care settings to participate in this non-interventional cross-sectional study. The original SPUR-45 tool was completed by participants with other patient-reported outcome measures for comparison, in addition to the collection of two objective adherence measures; HbA1c and the medication possession ratio (MPR).

Results: Factor and reliability analysis conducted on SPUR-45 produced a revised and more concise version (27-items) of the tool, SPUR-27, which was psychometrically assessed. SPUR-27 observed strong internal consistency with significant correlations to the other psychometric measures (Beliefs about Medication Questionnaire, Diabetes Treatment Satisfaction Questionnaire, Medicine Adherence Rating Scale) completed by participants. Higher SPUR-27 scores were associated with lower HbA1c values and a higher MPR, as well as other predicted socio-clinical factors such as higher income, increased age and lower body mass index.

Conclusions: SPUR-27 demonstrated strong psychometric properties. Further work should look to examine the test-retest reliability of the model as well as examine transferability to other chronic conditions and broader population samples. Overall, the initial findings suggest that SPUR-27 is a reliable model for the multifactorial assessment of medication adherence among patients living with type 2 diabetes.

Keywords: Diabetes & endocrinology; General diabetes; STATISTICS & RESEARCH METHODS.

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Conflict of interest statement

Competing interests: No other potential conflicts of interest relevant to this article were reported. JSW received funding from Observia to complete this work as part of their PhD, however, this funding only covered university fees such as tuition and the author did not and does not stand to receive any financial gain from involvement in this study.

Figures

Figure 1
Figure 1
Flow chart of study participant sampling procedure.
See this image and copyright information in PMC

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