Patient Preference and Adherence (Sep 2019)
Accountability in patient adherence
Abstract
Elias Oussedik1,2, Abigail Cline1, Jennifer J Su1, EJ Masicampo3, Lara K Kammrath3, Edward Ip4, Steven R Feldman1,5,6 1Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA; 2Faculty of Medicine, McGill University, Montreal, QC, Canada; 3Department of Psychology, Wake Forest University, Winston-Salem, NC, USA; 4Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA; 5Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA; 6Department of Dermatology, University of Southern Denmark, Odense, DenmarkCorrespondence: Abigail ClineCenter for Dermatology Resarch, Department of Dermatology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USATel +1 336 716 7740Fax +1 336 716 7732Email [email protected]: The accountability inherent in the social interaction between a patient and healthcare provider affects patients’ motivation to adhere to treatment. To characterize the role of accountability as a tool to improve self-efficacy and self-management and thereby promote patients’ adherence to treatment, a measure of accountability is needed.Aims: To develop and test the validity, reliability, and sensitivity of a new outcome measure designed to assess accountability.Methods: The accountability measurement tool was developed from the literature, expert consultation, and focus groups. A focus group and three pilot studies were performed both in clinic and through an online crowdsourcing platform. Principal Component Analysis evaluated constructs, and Cronbach’s alpha measured internal consistency. Validity was established using convergent and divergent correlations to other validated scales.Results: A total of 292 participants took part in this study. The 12-item accountability scale demonstrated very good internal consistency (Cronbach’s α=0.92). Components of the accountability measurement tool correlated with predicted validated measures, including the Treatment Self-Regulation Questionnaire. Divergent validity was established with no significant difference noted between age, sex, race, and education level.Conclusion: Future use of this questionnaire will allow for the assessment of the interaction between accountability and adherence to treatment and lead to the development of new interventions to promote better adherence.Keywords: accountability, adherence, self-determination theory, self-efficacy, patient behavior
