Skip to main content
SpringerLink
Log in

Item Reduction, Scoring, and First Validation of the ACCEPTance by the Patients of their Treatment (ACCEPT©) Questionnaire

  • Original Research Article
  • Published:
The Patient - Patient-Centered Outcomes Research Aims and scope Submit manuscript

Abstract

Objectives

The objectives of this study were to finalize, develop the scoring, and explore the psychometric properties of the ACCEPTance by the Patients of their Treatment (ACCEPT©) questionnaire, as well as to provide the first elements for its interpretation and guidance for its future use.

Methods

ACCEPT© was finalized according to reference methods including testing in a pilot study, i.e., a multi-center, observational, longitudinal study conducted in France, in collaboration with a network of pharmacists. Principal component analysis using Varimax rotation was performed. The loadings of items on components in the principal component analysis were used to inform item selection. Validity of the measurement model of ACCEPT© was confirmed using Multi-trait/Multi-item Analysis based on item-scale Spearman correlations. Internal consistency reliability of the questionnaire was assessed by determining the Cronbach’s α coefficient. Linear and logistic regressions were used to identify predictors of general acceptance, and to study predictors of persistence.

Results

A total of 189 patients were included. The final version of ACCEPT© is composed of 25 items, distributed in seven dimensions providing a comprehensive appraisal of acceptance of long-term medication, with six scores measuring acceptance of treatment specific attributes and one score measuring general treatment acceptance. The measurement properties of ACCEPT© were overall fairly satisfactory. Regressions showed that Acceptance/Effectiveness is a predictor of general acceptance. However, no predictor of persistence could be identified.

Conclusion

The self-administered ACCEPT© questionnaire is a valid and reliable instrument for the assessment of patients’ acceptance of long-term medication. Disease-specific and large prospective studies are needed to assess the ability of ACCEPT© to predict persistence with treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

(adapted from Marrant et al. [12])

Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sabaté E. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003. http://www.who.int/chp/knowledge/publications/adherence_report/en/. Accessed 20 Jan 2016.

  2. Clifford S, Barber N, Horne R. Understanding different beliefs held by adherers, unintentional nonadherers, and intentional nonadherers: application of the necessity-concerns framework. J Psychosom Res. 2008;64:41–6.

    Article  PubMed  Google Scholar 

  3. DiMatteo MR, Sherbourne CD, Hays RD, et al. Physicians’ characteristics influence patients’ adherence to medical treatment: results from the medical outcomes study. Health Psychol. 1993;12:93–102.

    Article  CAS  PubMed  Google Scholar 

  4. DiMatteo MR, Haskard KB, Williams SL. Health beliefs, disease severity, and patient adherence: a meta-analysis. Med Care. 2007;45:521–8.

    Article  PubMed  Google Scholar 

  5. Zolnierek KB, DiMatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care. 2009;47:826–34.

    Article  PubMed  Google Scholar 

  6. Rosenstock IM. The health belief model and preventive health behavior. Health Educ Monogr. 1974;2:354–86.

    Article  Google Scholar 

  7. Horne R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res. 1999;47:555–67.

    Article  CAS  PubMed  Google Scholar 

  8. Neame R, Hammond A. Beliefs about medications: a questionnaire survey of people with rheumatoid arthritis. Rheumatology (Oxford). 2005;44:762–7.

    Article  CAS  Google Scholar 

  9. Benson J, Britten N. What effects do patients feel from their antihypertensive tablets and how do they react to them? Qualitative analysis of interviews with patients. Fam Pract. 2006;23(1):80–7.

    Article  PubMed  Google Scholar 

  10. French LM, Smith MA, Holtrop JS, et al. Hormone therapy after the women’s health initiative: a qualitative study. BMC Fam Pract. 2006;7:61.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Turk DC, Dworkin RH, Allen RR, et al. Core outcome domains for chronic pain clinical trials: IMMPACT recommendations. Pain. 2003;106(3):337–45.

    Article  PubMed  Google Scholar 

  12. Marant C, Longin J, Gauchoux R, et al. Long-term treatment acceptance: what is it, and how can it be assessed? Patient. 2012;5(4):239–49.

    Article  PubMed  Google Scholar 

  13. Oliver RL. Satisfaction: a behavioral perspective on the consumer. New York: McGraw-Hill; 1997.

    Google Scholar 

  14. Cramer JA, Roy A, Burrell A, Fairchild CJ, et al. Medication compliance and persistence: terminology and definitions. Value Health. 2008;11(1):44–7.

    Article  PubMed  Google Scholar 

  15. European Medicines Agency. Guideline on pharmaceutical development of medicines for paediatric use: EMA/CHMP/QWP/805880/2012 Rev. 2. London: European Medicines Agency; Aug 2013. http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2013/07/WC500147002.pdf. Accessed 20 Jan 2016.

  16. Therapeutic Goods Administration. INTANZA product information: ARTG ID 150130. Australian Register of Therapeutic Goods. https://www.tga.gov.au/artg/artg-id-150130. Accessed 20 Jan 2016.

  17. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67–74.

    Article  CAS  PubMed  Google Scholar 

  18. Staquet MJ, Hays RD, Fayers PM. Quality of life assessment in clinical trials: methods and practice. Oxford: Oxford University Press; 1998.

    Google Scholar 

  19. Campbell DT, Fiske DW. Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull. 1959;56:81–105.

    Article  CAS  PubMed  Google Scholar 

  20. Hays RD, Hayashi T. Beyond internal consistency reliability: rationale and user’s guide for Multitrait analysis program on the microcomputer. Behav Res Methods Instrum Comput. 1990;22:167–75.

    Article  Google Scholar 

  21. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334.

    Article  Google Scholar 

  22. Nunnally JC, Bernstein IH. Psychometric theory. New York: McGraw-Hill Inc. 1994.

    Google Scholar 

  23. Atkinson MJ, Sinha A, Hass SL, et al. Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes. 2004;2:12.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Chevat C, Viala-Danten M, Dias-Barbosa C, Nguyen VH. Development and psychometric validation of a self-administered questionnaire assessing the acceptance of influenza vaccination: the Vaccinees’ Perception of Injection (VAPI) questionnaire. Health Qual Life Outcomes. 2009;7:21.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Schlarb AA, Brandhorst I. Mini-KiSS Online: an Internet-based intervention program for parents of young children with sleep problems: influence on parental behavior and children’s sleep. Nat Sci Sleep. 2012;4:41–52.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487–97.

    Article  CAS  PubMed  Google Scholar 

  27. Gifford AL, Bormann JE, Shively MJ, et al. Predictors of self-reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens. J Acquir Immune Defic Syndr. 2000;23:386–95.

    Article  CAS  PubMed  Google Scholar 

  28. Chesney MA. Factors affecting adherence to antiretroviral therapy. Clin Infect Dis. 2000;30(Suppl. 2):S171–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Remi Gauchoux for his support during the study.

Author Contributions

B. Arnould contributed to the study concept and design, the data analysis and interpretation, and reviewing of the manuscript. H. Gilet contributed to the data analysis and interpretation, and reviewing of the manuscript. D. Patrick contributed to the study concept and design, data interpretation, and reviewing of the manuscript. C. Acquadro contributed to the data analysis and interpretation, and writing of the manuscript.

Copyright

The ACCEPT© questionnaire is protected by copyright with all rights reserved to Mapi. Do not use this questionnaire without permission. For information on or permission to use the ACCEPT© questionnaire, please contact the MAPI Research Trust, 27 rue de la Villette, Lyon 69003, France. Telephone: +33 (0)472 13 65 75; https://eprovide.mapi-trust.org/instruments/chronic-treatment-acceptance-questionnaire. Review copies of the original French and US versions are available on the same website page (registration to the website is required).

Author information

Authors and Affiliations

  1. Patient-Centered Outcomes, Mapi, Lyon, France

    Benoit Arnould & Hélène Gilet

  2. Seattle Quality of Life Group and Biobehavioral Cancer Prevention and Training Program, University of Washington, Seattle, WA, USA

    Donald L. Patrick

  3. Mapi Research Trust, 27 rue de la Villette, 69003, Lyon, France

    Catherine Acquadro

Authors
  1. Benoit Arnould
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hélène Gilet
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Donald L. Patrick
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Catherine Acquadro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Catherine Acquadro.

Ethics declarations

The study was performed in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards, and in compliance with local regulatory requirements. The study protocol was submitted to and approved by the board of the French National Pharmacist Council (Ordre National des Pharmaciens) before study commencement. Study data were anonymized before data entry according to a procedure validated by the French Data Protection Authority (Commission Nationale Informatique et Libertés). Informed consent was obtained from all individual participants included in the study. Financial support for this study was provided by Mapi. B. Arnould is an employee of Mapi and H. Gilet was an employee of Mapi when the study was conducted. C. Acquadro was a paid consultant to Mapi. D. L. Patrick has no conflicts of interest to declare.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 28 kb)

Supplementary material 2 (DOCX 25 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arnould, B., Gilet, H., Patrick, D.L. et al. Item Reduction, Scoring, and First Validation of the ACCEPTance by the Patients of their Treatment (ACCEPT©) Questionnaire. Patient 10, 81–92 (2017). https://doi.org/10.1007/s40271-016-0187-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40271-016-0187-7

Keywords

Search

Navigation