Pharmacist-initiated adherence promotion activities for persons living with HIV in ambulatory care settings: Instrument development and initial psychometric testing

Jennifer Kibicho, Thomas Dilworth, Jill Owczarzak, Florine Ndakuya

Research output: Contribution to journalArticle

Abstract

Objectives: Consistent adherence to antiretroviral therapy (ART) remains a challenge for half the people living with HIV (PLWH) in the U.S. Pharmacists have the expertise in pharmacology and pharmacotherapeutics to manage ART and optimize PLWH outcomes. We developed and validated the psychometric properties of a scale to measure the breadth and depth of adherence promotion activities provided by pharmacists to PLWH in ambulatory care settings. Methods: An initial 37-item instrument was developed from 31 pharmacists' interviews and a comprehensive literature review. Psychometric properties were assessed from responses to questionnaires of 10 content experts and 184 ambulatory pharmacists in 37 States. Psychometric tests included: content validity index (CVI); Exploratory Factor Analysis (EFA); and internal reliability using Cronbach's alpha (α). Results: 26 items were eliminated in the item reduction stage. The final 11-item adherence promotion activities scale (APAS) was a single factor with high loadings (0.51–0.85), good internal consistency (α ≤ 0.93) and an explained variance of 60%. For known-groups validity, HIV-certified pharmacists had comparatively higher and statistically significant APAS score compared to non-certified pharmacists (4.00, p <.001). Conclusions: Preliminary psychometric testing—factor analysis, and high internal consistency—depict that APAS can be useful in scientific research and pharmacy practice to assess the nature and range of pharmacists’ above-and-beyond prescription services in real-world ambulatory settings. Further validation work is needed to establish conclusive reliability and validity of the newly developed scale.

Original languageEnglish (US)
JournalResearch in Social and Administrative Pharmacy
DOIs
StateAccepted/In press - Jan 1 2019

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Ambulatory Care
Pharmacists
Psychometrics
HIV
Testing
Factor analysis
Reproducibility of Results
Statistical Factor Analysis
Prescriptions
Pharmacology
Interviews
Therapeutics

Keywords

  • Adherence promotion activities
  • HIV
  • Instrument development
  • Patients
  • Pharmacists
  • Psychometrics

ASJC Scopus subject areas

  • Pharmacy
  • Pharmaceutical Science

Cite this

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title = "Pharmacist-initiated adherence promotion activities for persons living with HIV in ambulatory care settings: Instrument development and initial psychometric testing",
abstract = "Objectives: Consistent adherence to antiretroviral therapy (ART) remains a challenge for half the people living with HIV (PLWH) in the U.S. Pharmacists have the expertise in pharmacology and pharmacotherapeutics to manage ART and optimize PLWH outcomes. We developed and validated the psychometric properties of a scale to measure the breadth and depth of adherence promotion activities provided by pharmacists to PLWH in ambulatory care settings. Methods: An initial 37-item instrument was developed from 31 pharmacists' interviews and a comprehensive literature review. Psychometric properties were assessed from responses to questionnaires of 10 content experts and 184 ambulatory pharmacists in 37 States. Psychometric tests included: content validity index (CVI); Exploratory Factor Analysis (EFA); and internal reliability using Cronbach's alpha (α). Results: 26 items were eliminated in the item reduction stage. The final 11-item adherence promotion activities scale (APAS) was a single factor with high loadings (0.51–0.85), good internal consistency (α ≤ 0.93) and an explained variance of 60{\%}. For known-groups validity, HIV-certified pharmacists had comparatively higher and statistically significant APAS score compared to non-certified pharmacists (4.00, p <.001). Conclusions: Preliminary psychometric testing—factor analysis, and high internal consistency—depict that APAS can be useful in scientific research and pharmacy practice to assess the nature and range of pharmacists’ above-and-beyond prescription services in real-world ambulatory settings. Further validation work is needed to establish conclusive reliability and validity of the newly developed scale.",
keywords = "Adherence promotion activities, HIV, Instrument development, Patients, Pharmacists, Psychometrics",
author = "Jennifer Kibicho and Thomas Dilworth and Jill Owczarzak and Florine Ndakuya",
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T1 - Pharmacist-initiated adherence promotion activities for persons living with HIV in ambulatory care settings

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AU - Kibicho, Jennifer

AU - Dilworth, Thomas

AU - Owczarzak, Jill

AU - Ndakuya, Florine

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N2 - Objectives: Consistent adherence to antiretroviral therapy (ART) remains a challenge for half the people living with HIV (PLWH) in the U.S. Pharmacists have the expertise in pharmacology and pharmacotherapeutics to manage ART and optimize PLWH outcomes. We developed and validated the psychometric properties of a scale to measure the breadth and depth of adherence promotion activities provided by pharmacists to PLWH in ambulatory care settings. Methods: An initial 37-item instrument was developed from 31 pharmacists' interviews and a comprehensive literature review. Psychometric properties were assessed from responses to questionnaires of 10 content experts and 184 ambulatory pharmacists in 37 States. Psychometric tests included: content validity index (CVI); Exploratory Factor Analysis (EFA); and internal reliability using Cronbach's alpha (α). Results: 26 items were eliminated in the item reduction stage. The final 11-item adherence promotion activities scale (APAS) was a single factor with high loadings (0.51–0.85), good internal consistency (α ≤ 0.93) and an explained variance of 60%. For known-groups validity, HIV-certified pharmacists had comparatively higher and statistically significant APAS score compared to non-certified pharmacists (4.00, p <.001). Conclusions: Preliminary psychometric testing—factor analysis, and high internal consistency—depict that APAS can be useful in scientific research and pharmacy practice to assess the nature and range of pharmacists’ above-and-beyond prescription services in real-world ambulatory settings. Further validation work is needed to establish conclusive reliability and validity of the newly developed scale.

AB - Objectives: Consistent adherence to antiretroviral therapy (ART) remains a challenge for half the people living with HIV (PLWH) in the U.S. Pharmacists have the expertise in pharmacology and pharmacotherapeutics to manage ART and optimize PLWH outcomes. We developed and validated the psychometric properties of a scale to measure the breadth and depth of adherence promotion activities provided by pharmacists to PLWH in ambulatory care settings. Methods: An initial 37-item instrument was developed from 31 pharmacists' interviews and a comprehensive literature review. Psychometric properties were assessed from responses to questionnaires of 10 content experts and 184 ambulatory pharmacists in 37 States. Psychometric tests included: content validity index (CVI); Exploratory Factor Analysis (EFA); and internal reliability using Cronbach's alpha (α). Results: 26 items were eliminated in the item reduction stage. The final 11-item adherence promotion activities scale (APAS) was a single factor with high loadings (0.51–0.85), good internal consistency (α ≤ 0.93) and an explained variance of 60%. For known-groups validity, HIV-certified pharmacists had comparatively higher and statistically significant APAS score compared to non-certified pharmacists (4.00, p <.001). Conclusions: Preliminary psychometric testing—factor analysis, and high internal consistency—depict that APAS can be useful in scientific research and pharmacy practice to assess the nature and range of pharmacists’ above-and-beyond prescription services in real-world ambulatory settings. Further validation work is needed to establish conclusive reliability and validity of the newly developed scale.

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