Beyond Adherence Thresholds: A Simulation Study of the Optimal Classification of Longitudinal Adherence Trajectories From Medication Refill Histories

International audienceBackground: The description of adherence based on medication refill histories relies on the estimation of continuous medication availability (CMA) during an observation period. Thresholds to distinguish adherence from non-adherence typically refer to an aggregated value across the entire observation period, disregarding differences in adherence over time. Sliding windows to divide the observation period into smaller portions, estimating adherence for these increments, and classify individuals with similar trajectories into clusters can retain this temporal information. Optimal methods to estimate adherence trajectories to identify underlying patterns have not yet been established. This simulation study aimed to provide guidance for future studies by analyzing the effect of different longitudinal adherence estimates, sliding window parameters, and sample characteristics on the performance of a longitudinal clustering algorithm

Living with chronic pain - a longitudinal study of the interrelations between acceptance, emotions, illness perceptions and health status

Psychological adjustment to chronic pain has been recently explored within three separate frameworks: a behaviour-focused account of chronic pain acceptance within the broader remit of Acceptance and Commitment Therapy; an emotion-focused approach with various research programs investigating the role of anger, fear, depression and also shame and positive emotions in chronic pain; and a cognitionfocused perspective more recently reframed in terms of illness perceptions as part of a wider model of response to health threats, the Self-Regulatory Model. Although these frameworks have broad areas of overlap, limited research has been directed at integrating acceptance, emotions and illness perceptions into a common, comprehensive account of psychological adjustment to chronic pain. Such an account would be beneficial both for providing a parsimonious approach that would guide further research and for developing pain management interventions that would take advantage of existing research from all three domains. The aim of the present thesis was to explore the possibility of integrating these separate areas by studying the relationships between the main concepts (acceptance, emotions, and illness perceptions) in the context of chronic pain. Based on a review of the relevant conceptual and methodological issues of each domain, a theoretical analysis of the similarities and differences between them was developed, with particular emphasis on the potential of existing models to support an integrative account. This analysis provided specific hypotheses regarding each domain and the interrelationships between them, which were investigated in a longitudinal study on a heterogeneous sample of 265 chronic pain patients using the services of the NHS Lothian Pain Clinic and several patient support organisations. Data were collected via postal and online questionnaires at 3 time points, at 41/2-month intervals (21% attrition rate). Validated questionnaires were used to measure the relevant constructs, with additional questions obtaining information regarding health status, medical history and demographics. The confirmatory analysis (employing a variety of statistical procedures, from correlation to multiple regression, factor analysis, cluster analysis and structural equation modeling) largely confirmed the expected relations within and between domains and was also informative regarding the most suitable data reduction methods. A detailed psychometric analysis of the questionnaires used offered a complementary view on the theoretical and methodological issues involved. An additional exploratory analysis focused on identifying the comparative characteristics of acceptance, emotions, and illness perceptions in predicting health status indicators, controlling for contextual factors such as medical history and demographics. Although no significant longitudinal changes were identified in most parameters (confirming the clinical observation of chronic pain as a stable condition), the longitudinal data allowed an analysis of the stability of the concepts and of the magnitude of their relationships in this patient sample. The analysis of intra- and interpersonal variation via hierarchical longitudinal modeling confirmed the stability of the data, highlighted the necessity of studying variation at both levels, and revealed interesting moderation effects, explained via the proposed concept of ‘discrimination ability’ and several alternative mechanisms. These results can be considered as first steps towards an integrative model of psychological adjustment to chronic pain. It is proposed that the behavioural, cognitive and emotional aspects need further conceptual clarification and these future efforts can be supported by the Cognitive-Affective Model of the Interruptive Function of Pain, within the wider framework of the Self-Regulatory Model

Models for analysing the dependencies between indicators for bioeconomy in the European Union

In the past decade, bioeconomy has become a main field of interest, especially in terms of innovation, as it was often considered a potential solution to several global sustainability issues, such as environmental challenges. Through the conversion of biomass into value-added products for a full reintegration of used renewable biological resources, this sector has played a significant role in the efforts to transfer from petroleum-based economies to biobased economies. The present article has the objective of developing panel regression models for determining the dependency between some of the main indicators of the bioeconomy development and sustainability for the European Union in the period 2008–2013. One main interesting finding of the study emphasised that higher gas emissions from agriculture are associated positively with higher turnover in the bioeconomy, implying the fact that the development of the bioeconomy is surprisingly not necessarily associated with sustainability. The relevance of the present study lies in the novelty of the subject, as bioeconomy was mainly researched in terms of theoretical knowledge, but less in terms of statistical analysis. Thus, the article offers a comprehensive research regarding the connection of the bioeconomy quantifying indicators and other selected economic influence factors of the European Union

Mapping the Asthma Care Process : Implications for Research and Practice

The authors would like to thank the participants to the Respiratory Effectiveness Group Adherence symposium for their comments on the model overview presented during this meeting, members of the ASTRO-LAB consortium for collaborative work on reviewing literature and performing qualitative interviews, and patients and clinicians that shared valuable insights into asthma management during the telephone interviews. The research leading to these results has received funding from the European Community's 7th Framework (FP7/2007-2013) under grant agreement no. 282593.Peer reviewedPublisher PD

Development of the Persuasion Knowledge Scales of Sponsored Content (PKS-SC)

Despite the popularity of the Persuasion Knowledge Model, and its persistent relevance given the omnipresence of sponsored content (e.g. brand placement in TV programmes and video games, or paid product reviews in blogs), the way scholars measure persuasion knowledge varies widely. This study aims to develop valid and reliable scales for standardized measurement of consumers' persuasion knowledge of sponsored content. In three phases, we developed the Persuasion Knowledge Scales of Sponsored Content (PKS-SC) that measures nine components: (1) recognition of sponsored content, (2) understanding of selling and persuasive intent, (3) recognition of the commercial source of sponsored content, (4) understanding of persuasive tactics, (5) understanding of the economic model, (6) self-reflective awareness of the effectiveness of sponsored content, (7) skepticism toward sponsored content, (8) appropriateness of sponsored content, and (9) liking of sponsored content. All scales have good to appropriate validity and reliability. Recommendations for future research are discussed.</p

What We Mean When We Talk About Adherence In Respiratory Medicine

The Respiratory Effectiveness Group (REG; www.effectivenessevaluation.org) supported the Expert Adherence Panel Meeting at which many of the concepts presented in this paper were first discussed. REG also supported the manuscript submission costs. ALD, EvG, and MdB have received funding from the European Community's 7th Framework (FP7/2007-2013) under grant agreement no. 282593. Teva supported the meeting costs at which the concepts in this paper were discussed by the co-authors and the open access publication fee for this article. The authors had full editorial control over the ideas presented.Peer reviewedPublisher PD

The opportunities item response theory (IRT) offers to health psychologists : Methods in Health Psychology Symposium IV

Peer reviewedPublisher PD

Explaining the amount and consistency of medical care and self-management support in asthma : a survey of primary care providers in France and the United Kingdom

Copyright © 2018. Published by Elsevier Inc.Peer reviewedPostprin

Asthma inhaler adherence determinants in adults : systematic review of observational data

Copyright ©ERS 2014. Acknowledgements We would like to thank Eric van Ganse (Claude Bernard University Lyon 1, Lyon, France) and Marcel Bouvy (Utrecht University, Utrecht, the Netherlands) for valuable discussions regarding the systematic review process, and Dan Dediu (Max Plank Institute, Nijmegen, the Netherlands) for support with conducting the review and summarising results visuallyPeer reviewedPostprin