Search

BackgroundMedication adherence is important in managing the progression of chronic diseases. A promising approach to reduce cognitive burden when measuring medication adherence lies in the use of computer‐adaptive tests (CATs) or in the development of shorter patient-reported outcome measures (PROMs). However, the lack of an item bank currently hampers this progress. ObjectiveWe aim to develop an item bank to measure general medication adherence. MethodsUsing the preferred reporting items for systematic review and meta-analysis (PRISMA), articles published before October 2019 were retrieved from PubMed, Embase, CINAHL, the Cochrane Library, and Web of Science. Items from existing PROMs were classified and selected (“binned” and “winnowed”) according to standards published by the Patient-Reported Outcomes Measurement Information System (PROMIS) Cooperative Group. ResultsA total of 126 unique PROMs were identified from 213 studies in 48 countries. Items from the literature review (47 PROMs with 579 items for which permission has been obtained) underwent binning and winnowing. This resulted in 421 candidate items (77 extent of adherence and 344 reasons for adherence). ConclusionsWe developed an item bank for measuring general medication adherence using items from validated PROMs. This will allow researchers to create new PROMs from selected items and provide the foundation to develop CATs.

BackgroundMedication adherence is essential for improving the health outcomes of patients. Various patient-reported outcome measures (PROMs) have been developed to measure medication adherence in patients. However, no study has summarized the psychometric properties of these PROMs to guide selection for use in clinical practice or research. ObjectiveThis study aims to evaluate the quality of the PROMs used to measure medication adherence. MethodsThis study was guided by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Relevant articles were retrieved from the EMBASE, PubMed, Cochrane Library, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases. The PROMs were then evaluated based on the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. ResultsA total of 121 unique medication adherence PROMs from 214 studies were identified. Hypotheses testing for construct validity and internal consistency were the most frequently assessed measurement properties. PROMs with at least a moderate level of evidence for ≥5 measurement properties include the Adherence Starts with Knowledge 20, Compliance Questionnaire-Rheumatology, General Medication Adherence Scale, Hill-Bone Scale, Immunosuppressant Therapy Barrier Scale, Medication Adherence Reasons Scale (MAR-Scale) revised, 5-item Medication Adherence Rating Scale (MARS-5), 9-item MARS (MARS-9), 4-item Morisky Medication Adherence Scale (MMAS-4), 8-item MMAS (MMAS-8), Self-efficacy for Appropriate Medication Adherence Scale, Satisfaction with Iron Chelation Therapy, Test of Adherence to Inhalers, and questionnaire by Voils. The MAR-Scale revised, MMAS-4, and MMAS-8 have been administered electronically. ConclusionsThis study identified 121 PROMs for medication adherence and provided synthesized evidence for the measurement properties of these PROMs. The findings from this study may assist clinicians and researchers in selecting suitable PROMs to assess medication adherence.

Purpose: This paper aims to report on case-study research that explores the role of leadership practices, in particular, in enhancing the capacity of an enterprise to learn to create new value from a diverse range of sources. The capacity to sustain value creation over time, and across turbulent environments, increasingly differentiates enterprise performance. Under the umbrella term of "dynamic capabilities", a range of practices have been identified in the literature as contributing to an enterprise's ability to learn to perform this task successfully. Design/methodology/approach: The paper is based on case studies of three enterprises whose founders have sustained the creation of new value for customers over decades. Through a series of unstructured interviews with each founder, the tacit knowledge gained from years of learning how to create, and re-create, value, is made explicit through hermeneutic analysis of the interview transcripts. Findings: The data identify four key areas of leadership practice that underpin the capacity to learn to continuously create new value over significant periods of time. The most important of these are the social practices that generate and leverage the intangible capital resources (in particular, the resource of trust) that underpin the collaborative learning on which value creation processes depend. Research limitations/implications: As interpretive research, the knowledge accessed through this research is context-dependent and cannot be readily generalised. The validity of the knowledge is high, however, as the epistemological and ontological assumptions of the interpretive research paradigm recognise the political nature of organisations and, thus, of learning and value creation. As such, the knowledge generated by the case analyses offers a rich alternative perspective on the issue under research. Practical implications: The cases illuminate the nature of learning that supports continuous value creation in enterprises. Such learning is framed by several leadership practices that enable the self-reflexivity that underpins the continuous conversion of action-generated tacit knowledge into more strategically useful explicit knowledge. At the core of these leadership practices is stakeholder collaboration and intellectual humility. Social implications: The results show that learning to create sustainable value over time and diverse contexts, has a socio-political dimension in that it depends heavily on generating and leveraging the intangible resources (such as trust, commitment, ideas) that reside within social relationships. Originality/value: The research is located within the interpretive research paradigm and thus offers an alternative view to that of conventional positivist research. Furthermore, the results indicate that learning is a strategic priority in rapidly changing environments and, thus, is a key leadership responsibility. Furthermore, the results show that value creation is a collaborative stakeholder achievement.