How to study determinants related to medication adherence in newly diagnosed polyarthritis patients for the development of a prediction instrument.
INTRODUCTION
For patients with a chronic disease, the appropriate use of medication is the key to manage their illness. Adherence to medication is therefore important. Adherence can be divided into three parts: the initiation part, the execution phase, and the discontinuation part. Little is known about the determinants of the initiation part. For this reason, we describe the conduct of a stepwise procedure to study determinants of medication initiation for patients with a chronic disease.


METHODS/DESIGN
The stepwise procedure comprises of eliciting a list of all potential determinants via literature review, interviewing patients, and consulting an expert panel. This is followed by embedding the determinants in a theoretical framework, developing a questionnaire, and choosing adherence measurement methods. The consecutive steps that we conducted for the development of a tool for the prediction of adherence in our study sample of early arthritis patients are described.


DISCUSSION
Although we used a thorough procedure, there are still some pitfalls to take into account, such as the choice of theoretical framework. A strength of this study is that we use multiple adherence measurement methods and that we also take clinical outcomes into account.
['Pasma|Annelieke|A|', 'Hazes|Johanna Mw|JM|', 'Luime|Jolanda J|JJ|', 'Busschbach|Jan Jv|JJ|', "van 't Spijker|Adriaan|A|"]
medication adherence chronic disease arthritis methodology