Researchers' perspectives on methodological challenges and outcomes selection in interventional studies targeting medication adherence in rheumatic diseases: an OMERACT-adherence study.

Medication adherence Qualitative research Rheumatology

Journal

BMC rheumatology
ISSN: 2520-1026
Titre abrégé: BMC Rheumatol
Pays: England
ID NLM: 101738571

Informations de publication

Date de publication:
08 Jul 2021
Historique:
received: 21 10 2020
accepted: 09 04 2021
entrez: 8 7 2021
pubmed: 9 7 2021
medline: 9 7 2021
Statut: epublish

Résumé

Research on adherence interventions in rheumatology is limited by methodological issues, particularly heterogeneous outcomes. We aimed to describe researchers' experiences with conducting interventional studies targeting medication adherence in rheumatology and their perspectives on establishing core outcomes. Semi-structured interviews using audio conference were conducted with researchers who had conducted an adherence study of any design in the past 10 years. Data collection and thematic analysis were performed iteratively, until saturation. We interviewed 13 researchers, most of whom worked in academia and specialized in epidemiology and/or health services research. We identified three themes: 1) improving measurement of adherence (considering all phases of adherence, using appropriate and relevant measures, and establishing clinically meaningful thresholds); 2) challenges in designing and appraising adherence intervention studies (considering the confusion over a plethora of outcomes, difficulties with powering studies to demonstrate meaningful changes, and suboptimal descriptions of adherence interventions in published studies); and 3) advancing outcome assessment in adherence intervention studies (capturing rationale for developing a core domain set as well as recommendations and anticipated challenges by participants). Uniquely gathering perspectives from international adherence researchers, our findings led to researcher-informed recommendations for improving adherence research including specifying the targeted adherence phase in designing interventions and studies and providing a glossary of terms to promote consistency in reporting. We also identified recommendations for developing a core domain set for interventional studies targeting medication adherence including involvement of patients, clinicians, and other stakeholders and methodological and practical considerations to establish rigor and support uptake.

Sections du résumé

BACKGROUND BACKGROUND
Research on adherence interventions in rheumatology is limited by methodological issues, particularly heterogeneous outcomes. We aimed to describe researchers' experiences with conducting interventional studies targeting medication adherence in rheumatology and their perspectives on establishing core outcomes.
METHODS METHODS
Semi-structured interviews using audio conference were conducted with researchers who had conducted an adherence study of any design in the past 10 years. Data collection and thematic analysis were performed iteratively, until saturation.
RESULTS RESULTS
We interviewed 13 researchers, most of whom worked in academia and specialized in epidemiology and/or health services research. We identified three themes: 1) improving measurement of adherence (considering all phases of adherence, using appropriate and relevant measures, and establishing clinically meaningful thresholds); 2) challenges in designing and appraising adherence intervention studies (considering the confusion over a plethora of outcomes, difficulties with powering studies to demonstrate meaningful changes, and suboptimal descriptions of adherence interventions in published studies); and 3) advancing outcome assessment in adherence intervention studies (capturing rationale for developing a core domain set as well as recommendations and anticipated challenges by participants).
CONCLUSIONS CONCLUSIONS
Uniquely gathering perspectives from international adherence researchers, our findings led to researcher-informed recommendations for improving adherence research including specifying the targeted adherence phase in designing interventions and studies and providing a glossary of terms to promote consistency in reporting. We also identified recommendations for developing a core domain set for interventional studies targeting medication adherence including involvement of patients, clinicians, and other stakeholders and methodological and practical considerations to establish rigor and support uptake.

Identifiants

pubmed: 34233761
doi: 10.1186/s41927-021-00193-4
pii: 10.1186/s41927-021-00193-4
pmc: PMC8265120
doi:

Types de publication

Journal Article

Langues

eng

Pagination

26

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Auteurs

Shahrzad Salmasi (S)

Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
Arthritis Research Canada, Richmond, Canada.

Ayano Kelly (A)

College of Health and Medicine, Australian National University, Canberra, ACT, Australia.
Canberra Rheumatology, Canberra, ACT, Australia.
Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.

Susan J Bartlett (SJ)

Department of Medicine, McGill University and Research Institute, McGill University Health Centres, Montreal, Canada.
Division of Rheumatology, Johns Hopkins School of Medicine, Baltimore, MD, USA.

Maarten de Wit (M)

OMERACT Patient Research Partner, Amsterdam, Netherlands.

Lyn March (L)

Institute of Bone and Joint Research, Kolling Institute of Medical Research, Sydney, NSW, Australia.
Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW, Australia.
Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.

Allison Tong (A)

Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.
Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.

Peter Tugwell (P)

Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Kathleen Tymms (K)

College of Health and Medicine, Australian National University, Canberra, ACT, Australia.
Canberra Rheumatology, Canberra, ACT, Australia.
Department of Rheumatology, Canberra Hospital, Canberra, ACT, Australia.

Suzanne Verstappen (S)

Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.

Mary A De Vera (MA)

Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada. mdevera@mail.ubc.ca.
Arthritis Research Canada, Richmond, Canada. mdevera@mail.ubc.ca.

Classifications MeSH