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Development and Validation of the Parkinson's Disease Medication Beliefs Scale (PD-Rx).

ABSTRACT: Medication non-adherence is common in Parkinson's disease (PD) and is associated with increased disability and healthcare costs. Individuals' beliefs regarding their medical conditions and treatments impact medication adherence. While instruments exist to measure patients' beliefs about medications in general, no such tool exists for PD.Create an instrument eliciting medication beliefs of persons with PD; identify demographic and clinical characteristics associated with beliefs; and examine whether beliefs are associated with dopaminergic therapy adherence.We developed the Parkinson's Disease Medication Beliefs Scale (PD-Rx) in four phases: focus groups of patients and caregivers to generate items, scale development, expert and patient revision of items, and a cross-sectional validation sample (n?=?75). Adherence was calculated using two approaches incorporating self-reported medication lists.The PD-Rx consists of 11 items covering benefits and risks of PD pharmacotherapies. The scale covers motor improvement, current adverse effects, and future concerns. Higher scores indicate more positive beliefs. Internal consistency was acceptable (Cronbach's alpha?=?0.67). Test-retest reliability was 0.47. Quality of life was associated with PD-Rx scores, and lower scores were associated with non-adherence.Negative beliefs about PD treatments are associated with lower quality of life and may be related to medication non-adherence. Further study of any causal relationship between beliefs and medication non-adherence in PD will inform the design of future patient-centered interventions to improve adherence.

SUBMITTER: Fleisher JE

PROVIDER: S-EPMC4884139 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Development and Validation of the Parkinson's Disease Medication Beliefs Scale (PD-Rx).

Fleisher Jori E JE Dahodwala Nabila A NA Xie Sharon X SX Mayo Mark M Weintraub Daniel D Chodosh Joshua J Shea Judy A JA

Journal of Parkinson's disease 20160401 2

<h4>Background</h4>Medication non-adherence is common in Parkinson's disease (PD) and is associated with increased disability and healthcare costs. Individuals' beliefs regarding their medical conditions and treatments impact medication adherence. While instruments exist to measure patients' beliefs about medications in general, no such tool exists for PD.<h4>Objectives</h4>Create an instrument eliciting medication beliefs of persons with PD; identify demographic and clinical characteristics ass ...[more]

PMID: 27061070

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Project description:BackgroundMedication adherence is a crucial component in the management of patients with chronic diseases needing a long-term pharmacotherapy. Parkinson's disease (PD) is a chronic, degenerative disease with complex drug treatment that poses challenging barriers to patient adherence. The adoption of best practices of scale development can contribute to generate solid concepts and, in the long run, a more stable knowledge base on the underlying constructs of medication adherence in PD measured by the items of the first scale to be created for this purpose.PurposeTo present the development process and clinimetric testing plan of the Parkinson's Disease Medication Adherence Scale (PD-MAS).MethodWe adopted a hybrid approach plan based on the United States Food and Drug Administration and Benson and Clark Guide that will create a patient-reported outcome instrument. We presented an overview of consecutive and interrelated steps, containing a concise description of each one. International research centers from Brazil and United States were initially involved in the planning and implementation of the methodological steps of this study.ResultsWe developed a four-phase multimethod approach for the conceptualization and the clinimetric testing plan of the PD-MAS. First, we describe the development process of the conceptual framework of the PD-MAS underpinning the scale construct; second, we formalized the development process of the first version of the PD-MAS from the generation of item pools to the content validation and pre-testing; third, we established the steps for the first pilot testing and revision; fourth, we describe the steps plan for the first pilot testing and revision, to finally describe its clinimetric testing plan and validation.ConclusionThe overview presentation of the development phases and the clinimetric testing plan of the PD-MAS demonstrate the feasibility of creating an instrument to measure the multidimensional and multifactorial components of the medication adherence process in people with PD.

Project description:There is a high prevalence of mild cognitive impairment (MCI) and dementia in Parkinson's disease (PD) patients, but a Chinese version of cognitive rating scale that is specific and sensitive to PD patients is still lacking. The aims of this study are to test the reliability and validity of a Chinese version of Parkinson's disease-cognitive rating scale (PD-CRS), establish cutoff scores for diagnosis of Parkinson's disease dementia (PDD) and PD with mild cognitive impairment (PD-MCI), explore cognitive profiles of PD-MCI and PDD, and find cognitive deficits suggesting a transition from PD-MCI to PDD. PD-CRS was revised based on the culture background of Chinese people. Ninety-two PD patients were recruited in three PD centers and were classified into PD with normal cognitive function (PD-NC), PD-MCI, and PDD subgroups according to the cognitive rating scale (CDR). Those PD patients underwent PD-CRS blind assessment by a separate neurologist. The PD-CRS showed a high internal consistency (Cronbach's Alpha = 0.840). Intraclass Correlation coefficient (ICC) of test-retest reliability reached 0.906 (95% CI 0.860-0.935, p < 0.001). ICC of inter-rater reliability was 0.899 (95% CI 0.848-0.933, p < 0.001). PD-CRS had fair concurrent validity with MDRS (ICC = 0.731, 95% CI 0.602-0.816). All the frontal-subcortical items showed significant decrease in PD-MCI compared with the PD-NC group (p ≤ 0.001), but the instrument cortical items did not (confrontation naming p=0.717, copying a clock p=0.620). All the frontal-subcortical and instrumental-cortical functions showed significant decline in PDD compared with the PD-NC group (p ≤ 0.001). The cutoff value for diagnosis of PD-MCI is 80.5 with the sensitivity of 75.7% and the specificity of 75.0%, and for diagnosis of PDD is 73.5 with the sensitivity of 89.2% and the specificity of 98.9%. Revised Chinese version of PD-CRS is a reliable, acceptable, valid, and useful neuropsychological battery for assessing cognition in PD patients.

Dataset Information

Development and Validation of the Parkinson's Disease Medication Beliefs Scale (PD-Rx).

Publications

Development and Validation of the Parkinson's Disease Medication Beliefs Scale (PD-Rx).

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