BACKGROUND: Non-adherence to immunosuppressive medication is associated with graft loss and death. The simplified medication adherence questionnaire (SMAQ) is a short and reliable instrument for assessing adherence to medication. OBJECTIVE: Validation of a version of the SMAQ instrument adapted for use in transplant patients in a sample of kidney graft recipients. METHODS: Observational, longitudinal prospective study in 150 renal transplant patients on tacrolimus, over 18 years old, who had received a graft at least one year before. Basic sociodemographic and clinical data were recorded; patients completed the SMAQ twice (administered by doctor/nurse) and self-administered the Morisky-Green scale. The analysis database included 144 patients that met selection criteria and that provided the required data. Descriptive characteristics for all recorded parameters and psychometric characteristics of the questionnaire (reliability and validity) were studied. RESULTS: Mean age in the sample was 50.63 (12.44) years, 60.42% were men. Some 20.14% of patients had sub-target tacrolimus levels (<5 ng/ml), and unjustified variations in immunosuppressive drug levels were reported for 13.48%. Regarding SMAQ results, 39.01%/41.84% of patients were non-adherent (doctor/nurse administration); 22.38% according to the Morisky-Green scale. Interobserver agreement (kappa) was 0.821 (P<.001). The Cramer’s-V statistic for convergent validity was 0.516 (P<.001). SMAQ scores were associated with unjustified variations in tacrolimus levels. In the prediction of tacrolimus levels (target vs subtarget), SMAQ compared to Morisky-Green provided a better classification of patients, with greater sensitivity and lower specificity. CONCLUSION: The questionnaire provides good levels of validity and interobserver agreement. An enhanced sensitivity is advantageous to better detect non-adherent patients for a better follow-up.
BACKGROUND: Non-adherence to immunosuppressive medication is associated with graft loss and death. The simplified medication adherence questionnaire (SMAQ) is a short and reliable instrument for assessing adherence to medication. OBJECTIVE: Validation of a version of the SMAQ instrument adapted for use in transplant patients in a sample of kidney graft recipients. METHODS: Observational, longitudinal prospective study in 150 renal transplant patients on tacrolimus, over 18 years old, who had received a graft at least one year before. Basic sociodemographic and clinical data were recorded; patients completed the SMAQ twice (administered by doctor/nurse) and self-administered the Morisky-Green scale. The analysis database included 144 patients that met selection criteria and that provided the required data. Descriptive characteristics for all recorded parameters and psychometric characteristics of the questionnaire (reliability and validity) were studied. RESULTS: Mean age in the sample was 50.63 (12.44) years, 60.42% were men. Some 20.14% of patients had sub-target tacrolimus levels (<5 ng/ml), and unjustified variations in immunosuppressive drug levels were reported for 13.48%. Regarding SMAQ results, 39.01%/41.84% of patients were non-adherent (doctor/nurse administration); 22.38% according to the Morisky-Green scale. Interobserver agreement (kappa) was 0.821 (P<.001). The Cramer’s-V statistic for convergent validity was 0.516 (P<.001). SMAQ scores were associated with unjustified variations in tacrolimus levels. In the prediction of tacrolimus levels (target vs subtarget), SMAQ compared to Morisky-Green provided a better classification of patients, with greater sensitivity and lower specificity. CONCLUSION: The questionnaire provides good levels of validity and interobserver agreement. An enhanced sensitivity is advantageous to better detect non-adherent patients for a better follow-up.
Authors: Eng Hooi Tan; Andrea Li Ann Wong; Chuan Chien Tan; Patrick Wong; Sing Huang Tan; Li En Yvonne Ang; Siew Eng Lim; Wan Qin Chong; Jingshan Ho; Soo Chin Lee; Bee Choo Tai Journal: Breast Cancer Res Treat Date: 2021-05-04 Impact factor: 4.872
Authors: Helena Anglada-Martínez; Maite Martin-Conde; Marina Rovira-Illamola; Jose Miguel Sotoca-Momblona; Ethel Sequeira; Valentin Aragunde; M Angels Moreno; Marta Catalan; Carles Codina-Jané Journal: J Med Syst Date: 2016-02-12 Impact factor: 4.460
Authors: Tasmeen Hussain; Keira Nassetta; Linda C O'Dwyer; Jane E Wilcox; Sherif M Badawy Journal: Transplant Rev (Orlando) Date: 2021-09-20 Impact factor: 3.943
Authors: Jelena Lalić; Radmila Veličković-Radovanović; Branka Mitić; Goran Paunović; Tatjana Cvetković Journal: Med Princ Pract Date: 2014-06-06 Impact factor: 1.927
Authors: Yunxin He; Eng Hooi Tan; Andrea Li Ann Wong; Chuan Chien Tan; Patrick Wong; Soo Chin Lee; Bee Choo Tai Journal: BMC Cancer Date: 2018-07-09 Impact factor: 4.430
Authors: Siok Swan Tan; Marta M Pisano; An Ld Boone; Graham Baker; Yves-Marie Pers; Alberto Pilotto; Verushka Valsecchi; Sabrina Zora; Xuxi Zhang; Irene Fierloos; Hein Raat Journal: Int J Environ Res Public Health Date: 2019-05-28 Impact factor: 3.390
Authors: Eulalia Roig; Sonia Mirabet; Mar Gomis-Pastor; Jan T De Pourcq; Irene Conejo; Anna Feliu; Vicens Brossa; Laura Lopez; Andreu Ferrero-Gregori; Anna Barata; M Antonia Mangues Journal: JMIR Mhealth Uhealth Date: 2020-02-04 Impact factor: 4.773
Authors: Yu Heng Kwan; Livia Jia Yi Oo; Dionne Hui Fang Loh; Truls Østbye; Lian Leng Low; Hayden Barry Bosworth; Julian Thumboo; Jie Kie Phang; Si Dun Weng; Dan V Blalock; Eng Hui Chew; Kai Zhen Yap; Corrinne Yong Koon Tan; Sungwon Yoon; Warren Fong Journal: J Med Internet Res Date: 2020-10-08 Impact factor: 5.428
Authors: Eng Hooi Tan; Andrea Li Ann Wong; Chuan Chien Tan; Patrick Wong; Sing Huang Tan; Li En Yvonne Ang; Siew Eng Lim; Wan Qin Chong; Jingshan Ho; Soo Chin Lee; Bee Choo Tai Journal: Breast Date: 2020-07-02 Impact factor: 4.380