Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease

Mark J Atkinson, Anusha Sinha, Steven L Hass, Shoshana S Colman, Ritesh N Kumar, Meryl Brod, Clayton R Rowland, Mark J Atkinson, Anusha Sinha, Steven L Hass, Shoshana S Colman, Ritesh N Kumar, Meryl Brod, Clayton R Rowland

Abstract

Background: The objective of this study was to develop and psychometrically evaluate a general measure of patients' satisfaction with medication, the Treatment Satisfaction Questionnaire for Medication (TSQM).

Methods: The content and format of 55 initial questions were based on a formal conceptual framework, an extensive literature review, and the input from three patient focus groups. Patient interviews were used to select the most relevant questions for further evaluation (n = 31). The psychometric performance of items and resulting TSQM scales were examined using eight diverse patient groups (arthritis, asthma, major depression, type I diabetes, high cholesterol, hypertension, migraine, and psoriasis) recruited from a national longitudinal panel study of chronic illness (n = 567). Participants were then randomized to complete the test items using one of two alternate scaling methods (Visual Analogue vs. Likert-type).

Results: A factor analysis (principal component extraction with varimax rotation) of specific items revealed three factors (Eigenvalues > 1.7) explaining 75.6% of the total variance; namely Side effects (4 items, 28.4%, Cronbach's Alpha =.87), Effectiveness (3 items, 24.1%, Cronbach's Alpha =.85), and Convenience (3 items, 23.1%, Cronbach's Alpha =.87). A second factor analysis of more generally worded items yielded a Global Satisfaction scale (3 items, Eigenvalue = 2.3, 79.1%, Cronbach's Alpha =.85). The final four scales possessed good psychometric properties, with the Likert-type scaling method performing better than the VAS approach. Significant differences were found on the TSQM by the route of medication administration (oral, injectable, topical, inhalable), level of illness severity, and length of time on medication. Regression analyses using the TSQM scales accounted for 40-60% of variation in patients' ratings of their likelihood to persist with their current medication.

Conclusion: The TSQM is a psychometrically sound and valid measure of the major dimensions of patients' satisfaction with medication. Preliminary evidence suggests that the TSQM may also be a good predictor of patients' medication adherence across different types of medication and patient populations.

Figures

Figure 1
Figure 1
Mean Medication Satisfaction Levels by Route of Administration Notes: Effectiveness by Route, F(3,552) = 11.98, p < .0001 Side Effects by Route, F(3,552) = 5.87, P < .001 Convenience by Route, F(3, 552) = 58.92, p < .0001 Global by Route, F(3, 552) = 4.89, p < .01

References

    1. Golin CE, DiMatteo MR, Gelberg L. The role of patient participation in the doctor visit. Implications for adherence to diabetes care. Diabetes Care. 1996;19:1153–1164.
    1. Katz JN. Patient preferences and health disparities. JAMA. 2001;286:1506–1509. doi: 10.1001/jama.286.12.1506.
    1. Owens DK. Spine update. Patient preferences and the development of practice guidelines. Spine. 1998;23:1073–1079. doi: 10.1097/00007632-199805010-00023.
    1. Eriksen LR. Patient satisfaction with nursing care: concept clarification. Journal of Nursing Measurement. 1995;3:59–76.
    1. Gattellari M, Butow PN, Tattersall MH. Sharing decisions in cancer care. Soc Sci Med. 2001;52:1865–1878. doi: 10.1016/S0277-9536(00)00303-8.
    1. Turnbull JE, Luther KM. Patient satisfaction report paves way to improved care. QRC Advisor. 1996;13:1–7.
    1. Wright JG. Evaluating the outcome of treatment. Shouldn't We be asking patients if they are better? J Clin Epidemiol. 2000;53:549–553. doi: 10.1016/S0895-4356(99)00225-5.
    1. Brody D, Miller S, Lerman C, Smith D, Caputo G. Patient perception of involvement in medical care: Relationship to illness attitudes and outcomes. Journal of General Internal Medicine. 1989;4:506–511.
    1. Taylor TR. Understanding the choices that patients make. Journal of the American Board of Family Practice. 2000;13:124–133.
    1. Albrecht G, Hoogstraten J. Satisfaction as a determinant of compliance. Community Dent Oral Epidemiol. 1998;26:139–146.
    1. McCracken LM, Klock A, Mingay DJ, Asbury JK, Sinclair DM. Assessment of satisfaction with treatment for chronic pain. Journal of Pain & Symptom Management. 1997;14:292–299. doi: 10.1016/S0885-3924(97)00225-X.
    1. Weaver M, Patrick DL, Markson LE, Martin D, Frederic I, Berger M. Issues in the measurement of satisfaction with treatment. Am J Manag Care. 1997;3:579–594.
    1. Anderson RB, Hollenberg NK, Williams GH. Physical Symptoms Distress Index: a sensitive tool to evaluate the impact of pharmacological agents on quality of life. Archives of Internal Medicine. 1999;159:693–700. doi: 10.1001/archinte.159.7.693.
    1. Awad AG, Voruganti LN. Quality of life and new antipsychotics in schizophrenia. Are patients better off? Int J Soc Psychiatry. 1999;45:268–275.
    1. Diamond R. Drugs and the quality of life: the patient's point of view. Journal of Clinical Psychiatry. 1985;46:29–35.
    1. Adverse effects of the atypical antipsychotics. Collaborative Working Group on Clinical Trial Evaluations. J Clin Psychiatry. 1998;59:17–22.
    1. Gelber RD, Gelman RS, Goldhirsch A. A quality-of-life-oriented endpoint for comparing therapies. Biometrics. 1989;45:781–795.
    1. Gopalakrishna P, Mummalaneni V. Examination of the role of social class as a predictor of choice of health care provider and satisfaction received a model and empirical test. Journal of Ambulatory Care Marketing. 1992;5:35–48.
    1. Greiner DL, Addy SN. Sumatriptan use in a large group-model health maintenance organization. American Journal of Health-System Pharmacy. 1996;53:633–638.
    1. Llewellyn-Thomas HA. Investigating patients' preferences for different treatment options. Canadian Journal of Nursing Research. 1997;29:45–64.
    1. Schommer JC, Kucukarslan SN. Measuring patient satisfaction with pharmaceutical services. American Journal of Health-System Pharmacy. 1997;54:2721–2732.
    1. Robinson A, Thomson R. Variability in patient preferences for participating in medical decision making: implication for the use of decision support tools. Quality in Health Care. 2001;10:i34–i38.
    1. Fraenkel L, Bodardus S, Wittink DR. Understanding patient preferences for the treatment of lupus nephritis with adaptive conjoint analysis. Med Care. 2001;39:1203–1216. doi: 10.1097/00005650-200111000-00007.
    1. Hakim Z, Pathak DS. Modelling the EuroQol data: a comparison of discrete choice conjoint and conditional preference modelling. Health Economics. 1999;8:103–116. doi: 10.1002/(SICI)1099-1050(199903)8:2<103::AID-HEC393>;2-5.
    1. Lloyd AJ. The extent of patients' understanding of the risk of treatments. Quality in Health Care. 2001;10:i14–i18.
    1. Feighner JP. Impact of anxiety therapy on patients' quality of life. American Journal of Medicine. 1987;82:14–19.
    1. Bowling A, Ebrahim S. Measuring patients' preferences for treatment and perceptions of risk. Quality in Health Care. 2001;10:i2–i8.
    1. Dunbar-Jacob J, Erlen JA, Schlenk EA, Ryan CM, Sereika SM, Doswell WM. Adherence in chronic disease. Annual Review of Nursing Research. 2000;18:48–90.
    1. Bukstein DA. Incorporating quality of life data into managed care formulary decisions: a case study with salmeterol. Am J Manag Care. 1997;3:1701–1706.
    1. Fottler MD, Ford RC, Bach SA. Measuring patient satisfaction in healthcare organizations: qualitative and quantitative approaches. Best Pract Benchmarking Healthc. 1997;2:227–239.
    1. Ross CK, Steward CA, Sinacore JM. The importance of patient preferences in the measurement of health care satisfaction. Med Care. 1993;31:1138–1149.
    1. Aharony L, Strasser S. Patient satisfaction: what we know about and what we still need to explore. Medical Care Review. 1993;50:49–79.
    1. Strasser S, Aharony L, Greenberger D. The patient satisfaction process: moving toward a comprehensive model. Medical Care Review. 1993;50:219–248.
    1. Bredart A, Razavi D, Delvaux N, Goodman V, Farvacques C, Van Heer C. A comprehensive assessment of satisfaction with care for cancer patients. Supportive Care in Cancer. 1998;6:518–523. doi: 10.1007/s005200050207.
    1. Bredart A, Razavi D, Robertson C, Didier F, Scaffidi E, Fonzo D, Autier P, de Haes JC. Assessment of quality of care in an oncology institute using information on patients' satisfaction. Oncology. 2001;61:120–128. doi: 10.1159/000055362.
    1. Hudak PL, Wright JG. The characteristics of patient satisfaction measures. Spine. 2000;25:3167–3177. doi: 10.1097/00007632-200012150-00012.
    1. Lubeck DP, Litwin MS, Henning JM, Mathias SD, Bloor L, Carroll PR. An instrument to measure patient satisfaction with healthcare in an observational database: results of a validation study using data from CaPSURE. Am J Manag Care. 2000;6:70–76.
    1. Westbrook JI. Patient satisfaction: methodological issues and research findings. Australian Health Review. 1993;16:75–88.
    1. Avis M, Bond M, Arthur A. Satisfying solutions? A review of some unresolved issues in the measurement of patient satisfaction. J Adv Nurs. 1995;22:316–322. doi: 10.1046/j.1365-2648.1995.22020316.x.
    1. Bradley C. Diabetes treatment satisfaction questionnaire. Change version for use alongside status version provides appropriate solution where ceiling effects occur. Diabetes Care. 1999;22:530–532.
    1. Carr-Hill RA. The measurement of patient satisfaction. Journal of Public Health Medicine. 1992;14:236–249.
    1. Lin B, Kelly E. Methodological issues in patient satisfaction surveys. International Journal of Health Care Quality Assurance. 1995;8:32–37. doi: 10.1108/09526869510098840.
    1. Pouwer F, Snoek FJ, Heine RJ. Ceiling effect reduces the validity of the Diabetes Treatment Satisfaction Questionnaire. Diabetes Care. 1998;21:2039.
    1. Petterson T, Lee P, Hollis S, Young B, Newton P, Dornan T. Well-being and treatment satisfaction in older people with diabetes. Diabetes Care. 1998;21:930–935.
    1. Singh J, Wood VR, Goolsby J. Consumers' satisfaction with health care delivery: issues of measurement, issues of research design. Journal of Ambulatory Care Marketing. 1990;4:105–115.
    1. Sitzia J, Wood N. Response rate in patient satisfaction research: an analysis of 210 published studies. International Journal for Quality in Health Care. 1998;10:311–317. doi: 10.1093/intqhc/10.4.311.
    1. Sitzia J. How valid and reliable are patient satisfaction data? An analysis of 195 studies. International Journal for Quality in Health Care. 1999;11:319–328. doi: 10.1093/intqhc/11.4.319.
    1. Attkisson CC, Greenfield TK. The Consumer Satisfaction Questionnaire (CSQ) Scales and the Service Satisfaction Scale-30 (SSS-30) In: Sederer L, Dickey B, editor. In Outcomes Assessment in Clinical Practice. Baltimore: Williams & Wilkins; 1996. pp. 120–127.
    1. Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use. 2. Oxford, England: Oxford University Press; 1995.
    1. Williams SA, Swanson MS. The effect of reading ability and response formats on patients' abilities to respond to a patient satisfaction scale. Journal of Continuing Education in Nursing. 2001;32:60–67.
    1. Ware JE, Jr, Hays RD. Methods for measuring patient satisfaction with specific medical encounters. Med Care. 1988;26:393–402.
    1. Torrance GW, Feeny D, Furlong W. Visual analog scales: do they have a role in the measurement of preferences for health states? Medical Decision Making. 2001;21:329–334. doi: 10.1177/02729890122062622.
    1. Hanita M. Self-report measures of patient utility: should we trust them? J Clin Epidemiol. 2000;53:469–476. doi: 10.1016/S0895-4356(99)00205-X.
    1. Gill K. Social psychological artifacts in the measurement of consumer satisfaction with health care. Dissertation Abstracts International: Section B: The Sciences & Engineering. 1996;57:1495.
    1. Chatterton ML, Scott-Lennox J, Wu AW, Scott J. Quality of life and treatment satisfaction after the addition of lamivudine or lamivudine plus loviride to zidovudine-containing regimens in treatment-experienced patients with HIV infection. PharmacoEconomics. 1999;15 Suppl 1:67–74.
    1. Cohen JA, Beall D, Beck A, Rawlings J, Miller DW, Clements B, Pait DG, Batenhorst A. Sumatriptan treatment for migraine in a health maintenance organization: economic, humanistic, and clinical outcomes. Clinical Therapeutics. 1999;21:190–204. doi: 10.1016/S0149-2918(00)88278-8.
    1. Colman SS, Brod MI, Krishnamurthy A, Rowland CR, Jirgens KJ, Gomez-Mancilla B. Treatment satisfaction, functional status, and health-related quality of life of migraine patients treated with almotriptan or sumatriptan. Clinical Therapeutics. 2001;23:127–145. doi: 10.1016/S0149-2918(01)80036-9.
    1. Lewis R, Bennett CJ, Borkon WD, Boykin WH, Althof SE, Stecher VJ, Siegel RL. Patient and partner satisfaction with Viagra (sildenafil citrate) treatment as determined by the Erectile Dysfunction Inventory of Treatment Satisfaction Questionnaire. Urology. 2001;57:960–965. doi: 10.1016/S0090-4295(01)00945-1.
    1. Mathias SD, Warren EH, Colwell HH, Sung JC. A new treatment satisfaction measure for asthmatics: a validation study. Qual Life Res. 2000;9:873–882. doi: 10.1023/A:1008913209828.
    1. Payne R, Mathias SD, Pasta DJ, Wanke LA, Williams R, Mahmoud R. Quality of life and cancer pain: satisfaction and side effects with transdermal fentanyl versus oral morphine. Journal of Clinical Oncology. 1998;16:1588–1593.
    1. Glasser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. New York, Aldine de Gruyter; 1967.
    1. Krueger HP, Patton MQ. Focus Groups A practical guide for applied research. Newbury Park, Sage Publications; 1988.
    1. Merton RK, Friske M, Kendall PL. The Focused Interview A Manual of Problems and Procedures. 2. New York, The Free Press; 1990.
    1. Grogan S, Conner M, Norman P, Willits D, Porter I. Validation of a questionnaire measuring patient satisfaction with general practitioner services. Quality in Health Care. 2000;9:210–215. doi: 10.1136/qhc.9.4.210.
    1. Gorsuch RL. Exploratory factor analysis: Its role in item analysis. Journal of Personality Assessment. 1997;68:532–560.
    1. Gorsuch RL. New procedures for extension analysis in exploratory factor analysis. Educational and Psychological Measurement. 1997;57:725–740.
    1. Russell D. In search of underlying dimensions: The use (and abuse) of factor analysis in Personality and Social Psychology Bulletin. Personality and Social Psychology Bulletin. 2002;28:1629–1646. doi: 10.1177/014616702237645.
    1. Borner MM, Schoffski P, de Wit R, Caponigro F, Comella G, Sulkes A, Greim G, Peters GJ, van der BK, Wanders J, et al. Patient preference and pharmacokinetics of oral modulated UFT versus intravenous fluorouracil and leucovorin: a randomised crossover trial in advanced colorectal cancer. European Journal of Cancer. 2002;38:349–358. doi: 10.1016/S0959-8049(01)00371-9.
    1. Liu G, Franssen E, Fitch MI, Warner E. Patient preferences for oral versus intravenous palliative chemotherapy. Journal of Clinical Oncology. 1997;15:110–115.
    1. Stier DM, Gause D, Joseph WS, Schein JR, Broering JM, Warolin KL, Doyle JJ. Patient satisfaction with oral versus nonoral therapeutic approaches in onychomycosis. Journal of the American Podiatric Medical Association. 2001;91:521–527.
    1. Liem WH, McCullough JL, Weinstein GD. Effectiveness of topical therapy for psoriasis: results of a national survey. Cutis. 1995;55:306–310.
    1. Cronk BC, West JL. Personality research on the Internet: a comparison of Web-based and traditional instruments in take-home and in-class settings. Behavior Research Methods, Instruments, & Computers. 2002;34:177–180.
    1. Hatcher M. Internet usage and potential impact for acute care hospitals: survey in the United States. Journal of Medical Systems. 1998;22:371–378. doi: 10.1023/A:1020662124683.
    1. Ness TJ, Jones L, Smith H. Use of compounded topical analgesics – results of an Internet survey. Regional Anesthesia & Pain Medicine. 2002;27:309–312. doi: 10.1053/rapm.2002.31212.
    1. Rzymski P. A study of Internet use by doctors and patients in Poland. Journal of Telemedicine & Telecare. 2001;7:344–347. doi: 10.1258/1357633011936985.
    1. Duff S. Paying more for results. CMS tries to enlist Premier to tie hospital reimbursement to quality performance. Modern Healthcare. 2002;32:9.
    1. Clark PA. Medical practices' sensitivity to patients' needs. Opportunities and practices for improvement. Journal of Ambulatory Care Management. 2003;26:110–123.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever