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Development of the SPUR tool: a profiling instrument for patient treatment behavior

Author

Listed:
  • Béatrice Tugaut
  • Selam Shah
  • Kevin Dolgin
  • Hanna Rebibo Seror
  • Benoit Arnould
  • Marie-Eve Laporte

    (IAE Paris - Sorbonne Business School)

  • Aaron Lee
  • Lydiane Nabec
  • Reem Kayyali
  • Joshua Wells
  • John Piette
  • Guillaume Hubert

Abstract

Background: Long-term treatment adherence is a worldwide concern, with nonadherence resulting from a complex interplay of behaviors and health beliefs. Determining an individual's risk of nonadherence and identifying the drivers of that risk are crucial for the development of successful interventions for improving adherence. Here, we describe the development of a new tool assessing a comprehensive set of characteristics predictive of patients' treatment adherence based on the Social, Psychological, Usage and Rational (SPUR) adherence framework. Concepts from existing self-reporting tools of adherence-related behaviors were identified following a targeted MEDLINE literature review and a subset of these concepts were then selected for inclusion in the new tool. SPUR tool items, simultaneously generated in US English and in French, were tested iteratively through two rounds of cognitive interviews with US and French patients taking long-term treatments for chronic diseases. The pilot SPUR tool, resulting from the qualitative analysis of patients' responses, was then adapted to other cultural settings (China and the UK) and subjected to further rounds of cognitive testing. Results: The literature review identified 27 relevant instruments, from which 49 concepts were included in the SPUR tool (Social: 6, Psychological: 13, Usage: 11, Rational: 19). Feedback from US and French patients suffering from diabetes, multiple sclerosis, or breast cancer (n = 14 for the first round; n = 16 for the second round) indicated that the SPUR tool was well accepted and consistently understood. Minor modifications were implemented, resulting in the retention of 45 items (Social: 5, Psychological: 14, Usage: 10, Rational: 16). Results from the cognitive interviews conducted in China (15 patients per round suffering from diabetes, breast cancer or chronic obstructive pulmonary disease) and the UK (15 patients suffering from diabetes) confirmed the validity of the tool content, with no notable differences being identified across countries or chronic conditions. Conclusion Our qualitative analyses indicated that the pilot SPUR tool is a promising model that may help clinicians and health systems to predict patient treatment behavior. Further steps using quantitative methods are needed to confirm its predictive validity and other psychometric properties.

Suggested Citation

  • Béatrice Tugaut & Selam Shah & Kevin Dolgin & Hanna Rebibo Seror & Benoit Arnould & Marie-Eve Laporte & Aaron Lee & Lydiane Nabec & Reem Kayyali & Joshua Wells & John Piette & Guillaume Hubert, 2022. "Development of the SPUR tool: a profiling instrument for patient treatment behavior," Post-Print halshs-03689578, HAL.
    • Handle: RePEc:hal:journl:halshs-03689578
    DOI: 10.1186/s41687-022-00470-x
    Note: View the original document on HAL open archive server: https://shs.hal.science/halshs-03689578v1
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    References listed on IDEAS

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    1. Ajzen, Icek, 1991. "The theory of planned behavior," Organizational Behavior and Human Decision Processes, Elsevier, vol. 50(2), pages 179-211, December.
    2. Fisher, Robert J, 1993. "Social Desirability Bias and the Validity of Indirect Questioning," Journal of Consumer Research, Journal of Consumer Research Inc., vol. 20(2), pages 303-315, September.
    3. Benoit Arnould & Hélène Gilet & Donald L. Patrick & Catherine Acquadro, 2017. "Item Reduction, Scoring, and First Validation of the ACCEPTance by the Patients of their Treatment (ACCEPT©) Questionnaire," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 10(1), pages 81-92, February.
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