Skip to main content

Advertisement

SpringerLink
Log in

Factorial invariance of a questionnaire assessing medication beliefs in Japanese non-adherent groups

  • Research Article
  • Published:
Pharmacy World & Science Aims and scope Submit manuscript

Abstract

Objective The aim of our study was to verify invariance of latent factors derived from the BMQ (Belief about Medicines Questionnaire) among Japanese adherent and non-adherent groups (adherent to medication and intentionally, unintentionally, and overlapping non-adherent groups) and to estimate mean differences of the latent factors among the groups. Setting A Japanese university hospital. Methods After administration of a cross-sectional survey, covariance structure analyses of the two-factor model were conducted. Groups that exhibited factorial invariance were identified, and structured mean analyses estimated the differences of the latent means of the factors between groups using the bootstrap method without relying on theoretical assumptions for sampling distributions. Effect size was employed as an indicator of these differences. Main outcome measure The differences in the latent means of the two factors (the necessity and concerns factors for prescribed medications) across the groups exhibiting factorial invariance, which reflect true differences between them. Results Factorial invariance was demonstrated only across adherent and unintentionally non-adherent groups. Unintentionally non-adherent patients had significantly lower latent means for the necessity factor than adherent patients, with a very close to medium effect size (−0.49; 95% CI −0.84, −0.14; bootstrap method). Conclusion A meaningful comparison of BMQ scale scores can be made between adherent and unintentionally non-adherent groups of Japanese patients.

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

Similar content being viewed by others

References

  1. World Health Organization. Adherence to long-term therapies: evidence for action. Geneva: World Health Organization; 2003. ISBN 9241545992.

  2. Haynes RB, Yao X, Degani A, Kripalani S, Garg A, McDonald HP. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008: CD000011. doi:10.1002/14651858.

  3. Iihara N, Kurosaki Y, Miyoshi C, Takabatake K, Morita S, Hori K. Comparison of individual perceptions of medication costs and benefits between intentional and unintentional medication non-adherence among Japanese patients. Patient Educ Couns. 2008;70:292–9.

    Article  PubMed  Google Scholar 

  4. Atkins L, Fallowfield L. Intentional and non-intentional non-adherence to medication amongst breast cancer patients. Eur J Cancer. 2006;42:2271–6.

    Article  PubMed  Google Scholar 

  5. Lowry KP, Dudley TK, Oddone EZ, Bosworth HB. Intentional and unintentional nonadherence to antihypertensive medication. Ann Pharmacother. 2005;39:1198–203.

    Article  PubMed  Google Scholar 

  6. Wroe AL, Thomas MG. Intentional and unintentional nonadherence in patients prescribed HAART treatment regimens. Psychol Health Med. 2003;8:453–63.

    Article  Google Scholar 

  7. Wroe AL. Intentional and unintentional nonadherence: a study of decision making. J Behav Med. 2002;25:355–72.

    Article  PubMed  Google Scholar 

  8. 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 

  9. Barber N. Should we consider non-compliance a medical error? Qual Saf Health Care. 2002;11:81–4.

    Article  CAS  PubMed  Google Scholar 

  10. Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14:1–24.

    Article  Google Scholar 

  11. 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 

  12. Horne R, Buick D, Fisher M, Leake H, Cooper V, Weinman J. Doubts about necessity and concerns about adverse effects: identifying the types of beliefs that are associated with non-adherence to HAART. Int J STD AIDS. 2004;15:38–44.

    Article  PubMed  Google Scholar 

  13. Phatak HM, Thomas J III. Relationships between beliefs about medications and nonadherence to prescribed chronic medications. Ann Pharmacother. 2006;40:1737–42.

    Article  PubMed  Google Scholar 

  14. Butler JA, Peveler RC, Roderick P, Smith PW, Horne R, Mason JC. Modifiable risk factors for non-adherence to immunosuppressants in renal transplant recipients: a cross-sectional study. Nephrol Dial Transplant. 2004;19:3144–9.

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  16. Bentler PM, Stein JA. Structural equation models in medical research. Stat Methods Med Res. 1992;1:159–81.

    Article  CAS  PubMed  Google Scholar 

  17. Hoyle RH, Smith GT. Formulating clinical research hypotheses as structural equation models: a conceptual overview. J Consult Clin Psychol. 1994;62:429–40.

    Article  CAS  PubMed  Google Scholar 

  18. Byrne BM. Structural equation modeling with AMOS: basic concepts, applications, and programming. Mahwah: Lawrence Erlbaum Associates; 2001. ISBN 0-8058-3322-6.

  19. Loehlin JC. Latent variable models: an introduction to factor, path, and structural equation analysis. 4th ed. Mahwah: Lawrence Erlbaum Associates; 2004. ISBN 0-8058-4910-6.

  20. Motl RW, Dishman RK, Dowda M, Pate RR. Factorial validity and invariance of a self-report measure of physical activity among adolescent girls. Res Q Exerc Sport. 2004;75:259–71.

    PubMed  Google Scholar 

  21. Hales DP, Dishman RK, Motl RW, Addy CL, Pfeiffer KA, Pate RR. Factorial validity and invariance of the Center for Epidemiologic Studies Depression (CES-D) Scale in a sample of black and white adolescent girls. Ethn Dis. 2006;16:1–8.

    PubMed  Google Scholar 

  22. Haynes RB, McDonald HP, Garg AX. Helping patients follow prescribed treatment: clinical applications. J Am Med Assoc. 2002;288:2880–3.

    Article  Google Scholar 

  23. 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 

  24. Marsh HW. Confirmatory factor analysis models of factorial invariance: a multifaceted approach. Struct Equ Model. 1994;1:5–34.

    Article  Google Scholar 

  25. Motl RW, Dishman RK, Trost SG, Saunders RP, Dowda M, Felton G, et al. Factorial validity and invariance of questionnaires measuring social-cognitive determinants of physical activity among adolescent girls. Prev Med. 2000;31:584–94.

    Article  CAS  PubMed  Google Scholar 

  26. Marsh HW. The multidimensional structure of physical fitness: invariance over gender and age. Res Q Exerc Sport. 1993;64:256–73.

    CAS  PubMed  Google Scholar 

  27. Kawabata K. Multiple-group analysis. In: Toyoda H, editor. Covariance structure analysis: AMOS. Tokyo, Japan: TokyoTosho; 2007. ISBN 978-4-489-02008-7.

  28. Dishman RK, Hales DP, Almeida MJ, Pfeiffer KA, Dowda M, Pate RR. Factorial validity and invariance of the physical self-description questionnaire among black and white adolescent girls. Ethn Dis. 2006;16:551–8.

    PubMed  Google Scholar 

  29. Akaike H. Factor analysis and AIC. Psychometrika. 1987;52:317–32.

    Article  Google Scholar 

  30. Marsh HW, Balla JR, McDonald RP. Goodness-of-fit indexes in confirmatory factor analysis: the effect of sample size. Psychol Bull. 1988;102:391–410.

    Article  Google Scholar 

  31. Hu L, Bentler PM. Cutoff criteria for fit indices in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model. 1999;6:1–55.

    Article  Google Scholar 

  32. Bentler PM. Comparative fit indexes in structural models. Psychol Bull. 1990;107:238–46.

    Article  CAS  PubMed  Google Scholar 

  33. Browne MW, Cudeck R. Alternative ways of assessing model fit. Sociol Methods Res. 1992;21:230–58.

    Article  Google Scholar 

  34. Ullman JB. Structural equation modeling. In: Tabachnick BG, Fidell LS, editors. Using multivariate statistics. 4th ed. Needham Heights: Allyn and Bacon; 2000. p. 653–771. ISBN 978-0321056771.

  35. Taub GE, McGrew KS. A confirmatory factor analysis of Cattell-Horn-Carroll theory and cross-age invariance of the Woodcock-Johnson tests of cognitive abilities 3. Sch Psychol Q. 2004;19:72–87.

    Article  Google Scholar 

  36. Efron B. Bootstrap methods: another look at the jackknife. Ann Stat. 1979;7:1–26.

    Article  Google Scholar 

  37. Fukunaka K. Latent structured mean analysis for multi-group. In: Toyoda H, editor. Covariance structure analysis: AMOS. Tokyo, Japan: TokyoTosho; 2007. ISBN 978-4-489-02008-7.

  38. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1988. ISBN 978-0805802832.

  39. von Neumann J, Morgenstern O. Theory of games and economic behaviour. Princeton: Princeton University Press; 1980. ISBN 978-0691003627.

  40. Horne R, Weinman J. Self-regulation and self-management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychol Health. 2002;17:17–32.

    Article  Google Scholar 

  41. DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42:200–9.

    Article  PubMed  Google Scholar 

  42. Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G. The rational clinical examination. Is this patient taking the treatment as prescribed? J Am Med Assoc. 1993;269:2779–81.

    Article  CAS  Google Scholar 

  43. Schroeder K, Fahey T, Hay AD, Montgomery A, Peters TJ. Adherence to antihypertensive medication assessed by self-report was associated with electronic monitoring compliance. J Clin Epidemiol. 2006;59:650–1.

    Article  PubMed  Google Scholar 

  44. MacCallum RC, Roznowski M, Necowitz LB. Model modifications in covariance structure analysis: the problem of capitalization on chance. Psychol Bull. 1992;111:490–504.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank all who replied to our interview and questionnaire.

Funding

No external sources of funding for this study were obtained.

Conflicts of interest statement

The authors have no conflicts of interests.

Author information

Authors and Affiliations

  1. Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, 1314-1, Shido, Sanuki-city, Kagawa, 769-2193, Japan

    Naomi Iihara

  2. Department of Pharmacy, Kagawa University Hospital, Kagawa, Japan

    Kiyo Suzuki

  3. Faculty of Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan

    Yuji Kurosaki

  4. Faculty of Pharmaceutical Sciences, Hiroshima International University, Hiroshima, Japan

    Shushi Morita

  5. Faculty of Economics, Kagawa University, Kagawa, Japan

    Keizo Hori

Authors
  1. Naomi Iihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kiyo Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuji Kurosaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shushi Morita
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Keizo Hori
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Naomi Iihara.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Iihara, N., Suzuki, K., Kurosaki, Y. et al. Factorial invariance of a questionnaire assessing medication beliefs in Japanese non-adherent groups. Pharm World Sci 32, 432–439 (2010). https://doi.org/10.1007/s11096-010-9388-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-010-9388-7

Keywords

Search

Navigation