Accountability in patient adherence
Received 23 April 2019
Accepted for publication 27 August 2019
Published 4 September 2019 Volume 2019:13 Pages 1511—1517
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
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, Denmark
Correspondence: Abigail Cline
Center for Dermatology Resarch, Department of Dermatology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA
Tel +1 336 716 7740
Fax +1 336 716 7732
Background: 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
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