The compliance-questionnaire-rheumatology compared with electronic medication event monitoring: a validation study

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J Rheumatol. 2003 Nov;30(11):2469-75.

The compliance-questionnaire-rheumatology compared with electronic

medication event monitoring: a validation study.

de Klerk E, van der Heijde D, Landewe R, van der Tempel H, van der

Linden S.

Department of Internal Medicine, Division of Rheumatology, University

Hospital Maastricht, 6202 AZ Maastricht, The Netherlands.

OBJECTIVE: To validate the 19-item Compliance-Questionnaire-Rheumatology

(CQR) against the " gold standard " in compliance measurement, electronic

medication event monitoring. METHODS: Among 127 consenting patients, 81

with rheumatoid arthritis taking nonsteroidal antiinflammatory drugs (13

diclofenac, 20 naproxen) or disease modifying antirheumatic drugs (25

sulfasalazine, 23 methotrexate), 17 patients with polymyalgia rheumatica

taking prednisone, and 29 patients with gout taking daily prophylactic

colchicine (n = 12) or the uric acid lowering drugs allopurinol (10) or

benzbromaron (7), 104 used their medication from a regular medication

bottle fitted with a special cap containing microelectronics capable of

recording time and date of opening and closing, defined as a medication

event. Data were processed for the following: (1) the percentage of

prescribed medication events during the study period (taking compliance)

and (2) the percentage of days with the prescribed number of medication

events (i.e., correct dosing). Satisfactory compliance was defined as

taking compliance or correct dosing > 80%, while unsatisfactory

compliance was defined as taking compliance or correct dosing < or =

80%. All patients were informed about the monitoring, and were followed

for 6 months (gout: 1 year). At baseline 85 patients completed a set of

questionnaires including the 19-item CQR. RESULTS: A total of 85

patients who had complete questionnaire and electronic monitoring data

were analyzed. Multiple linear regression analyses showed that the

total, weighted CQR score significantly and adequately predicts taking

compliance (p = 0.001, r2 = 0.46) and correct dosing (p = 0.004, r2 =

0.42). Discriminant analyses showed that specificity and sensitivity to

detect good taking compliance were 95% and 62%, respectively, with a

prevalence of good compliance of 52%. The predictive value to detect

unsatisfactory taking compliance was 86%, and to detect good taking

compliance was 83%. The likelihood ratio of the CQR-19 to detect low

taking compliance was 11.6. Four items were especially predictive: fear

of forgetting to take the drug, being able to function well, routines in

daily life, and side effects (combined r2 = 0.35).

CONCLUSION: These results support the validity of the Compliance

Questionnaire Rheumatology.

Publication Types:

a.. Validation Studies

PMID: 14677194