Assessing the medication adherence report scale as a tool in pediatric asthma

Thesis (M.A.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.Asthma is the leading chronic illness in the pediatric population and affects more than 7 million children in the United States. Although effective preventive medications are available, medication nonadherence in children and adolescents continues to soar. Understanding trends and gaining insight from associations between psychometric tests can improve asthma control. The purpose of this study is to validate the use of MARS-A (Medication Adherence Report Scale) as a tool in assessing asthma medication adherence in a pediatric population as well as finding relationships between individual MARS-A items and other asthma control measures. One hundred fifty six patients diagnosed with asthma were recruited to complete the Asthma Control Test (ACT) and MARS-A questionnaire for analysis. The results demonstrated that the MARS-A had good internal validity with a Cronbach-a of 0.81 for all data, which includes multiple visits per patient. A separate analysis of internal validity was performed to factor in sensitivity, using the first and last visit's data only showing once again, good internal consistency (Cronbach-a 0.84 for the first visit dates and 0.83 for the last visit dates). Furthermore, the MARS-A showed good criterion validity with AMR, ACT, and Childhood-ACT (p=0.24, p=0.0036; p=0.31, p=0.000024; p=0.31 , p=0.00017, respectively). Sensitivity analysis across these values demonstrated similar results. Patients who reported high adherence according to MARS-A (score of 46 or higher) had a 3-fold higher odds of scoring higher on the C-ACT (odds ratio (OR)= 3.07; 95% confidence interval [CI] = 1.49-6.31 , p = 0.002). If a patient scored 0.5 or higher on the AMR, then they are 2.6 times more likely to score greater than or equal to 46 on the MARS-A, further supporting good criterion validity. [TRUNCATED