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. 2025 Aug 11:19:2429-2444.
doi: 10.2147/PPA.S516285. eCollection 2025.

Identifying Dimensions and Items for a Questionnaire to Assess Medication Adherence in Men and Women with Ischemic Heart Disease: Insights from the GENADHECAR Study

Álvaro Carbonell-Soliva #  1   2 , Rauf Nouni-García #  2   3   4   5 , Jose A Quesada  1   2   4 , Francisco González-Llopis  6 , Alberto Cordero  7   8   9 , Vicente Bertomeu-González  10 , Domingo Orozco-Beltrán  1   2   4 , José Verdú-Soriano  11 , Andreu Nolasco  12 , Virtudes Pérez-Jover  13 , Jose Joaquín Mira  13   14 , Adriana López-Pineda  1   2   4 , Silvia Guillén-García  15 , Pablo Martínez-Pérez  16 , Concepción Carratalá-Munuera #  1   2   4 , Vicente F Gil-Guillén #  1   2   4 ; GENADHECAR Group; Collaborators
Collaborators, Affiliations

Identifying Dimensions and Items for a Questionnaire to Assess Medication Adherence in Men and Women with Ischemic Heart Disease: Insights from the GENADHECAR Study

Álvaro Carbonell-Soliva et al. Patient Prefer Adherence. .

Abstract

Purpose: The objective of this study was to identify dimensions and items for a future questionnaire aimed at measuring medication nonadherence in people with ischemic heart disease, considering gender differences and incorporating the views of healthcare professionals, researchers, and patients.

Patients and methods: We conducted a mixed-method cross-sectional study at San Juan de Alicante University Hospital and Miguel Hernández University (Spain). The methods used to identify dimensions included a consensus group of healthcare and scientific professionals, an open-response survey for community pharmacists, a closed-response patient survey, and patient focus groups. When drafting the item list, we followed international recommendations related to the number and wording of items. Our study also included a qualitative review of the item list and response scales by psychologists.

Results: The resulting item list includes 41 potential items grouped into 26 dimensions and five domains: "patient", "treatment", "disease", "health professional-patient relationship" and "healthcare system". It covers aspects such as personal beliefs, mood, polypharmacy, disease symptoms, patient-healthcare professional interaction and healthcare system factors. Response options are presented on a 5-point Likert scale, including agreement-level responses and frequency-level responses.

Conclusion: With the collaboration of patients, researchers, and healthcare providers, we potentially identified five domains, 26 dimensions, and 41 items with 5-point Likert scale response options. These will be considered in the subsequent development and validation of a questionnaire to measure medication adherence in patients with ischemic heart disease.

Keywords: cardiovascular disease; gender perspective; item development; medication nonadherence; mixed-methods research.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

None
Graphical abstract
Figure 1
Figure 1
Diagram of the study’s mixed methods design.
Figure 2
Figure 2
Consecutive phases of healthcare and scientific professionals consensus group.
Figure 3
Figure 3
Process of recruiting community pharmacists and collecting and analyzing data.
Figure 4
Figure 4
Flowchart illustrating the qualitative review of the initial list of items: exclusion, unchanged items, reformulation, and inclusion of new items.
Figure 5
Figure 5
Flowchart illustrating the qualitative review of the initial list of items: exclusion and reformulation of dimensions.
See this image and copyright information in PMC

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