Matrix: Non-Adherence among Hypertensive African American Males

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Development and evaluation of a medication adherence self-efficacy scale in hypertensive African-American patients
Gbenga Ogedegbea*, Carol A. Mancusoa,b, John P. Allegrantec, Mary E. Charlsona
3Department of Medicine, Weill Medical College of Cornell University, 525 East 68th Street, Box 46, New York, NY 10021, USA bThe Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA cDepartment of Health and Behavior Studies, and National Center for Health Education, Teachers College, Columbia University, 525 West 120th Street, New York, NY 10027, USA Received 8 August 2002; received in revised form 31 January 2003; accepted 16 February 2003

Self-efficacy, a known predictor of a wide range of health behaviors, has not been investigated in studies of adherence to antihypertensive medications. A medication adherence self-efficacy scale was developed and evaluated in ambulatory hypertensive African-American patients in two sequential phases. For the item-generation phase, open-ended interviews with 106 patients were used to elicit their experiences with taking antihypertensive medications. Using qualitative techniques, responses were recorded verbatim, coded, and sorted into nine categories of barriers and facilitators of medication adherence. Concepts from categories were formatted into an initial 43-item self-efficacy questionnaire, which was administered to another group of 72 patients for the item analyses phase. Twenty-six items were retained for the final self-efficacy scale based on item-to-total correlation coefficient > 0.5, kappa > 0.4, and clinical relevance of individual items. Clinicians and researchers can use this scale to identify situations in which patients have low self-efficacy in adhering to prescribed medications.

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