Is E-Version Transition of the Medication Adherence Scale Feasible for CKD Management? A Pilot Study

Figures & data

Figure 1 Issuing and design of the electronic Chinese and western medication adherence questionnaire.

Table 1 Clinical Profiles of the 434 Patients Invited to Participate

Characteristics		Participants (n=434)
Age, years		49.00 (37.0, 61.0)
Sex	Male	222 (51.2%)
	Female	212 (48.8%)
Marital status	Unmarried	57 (13.1%)
	Married	370 (85.3%)
	Other	7 (1.6%)
SCr, μmol/L		102.5 (79.8, 160.3)
eGFR, mL/min/1.73 m2		63.3 (35.3, 91.1)
CKD stage	1	108 (24.9%)
	2	109 (25.1%)
	3	141 (32.5%)
	4	46 (10.6%)
	5	30 (6.9%)
Education level	Primary school	39 (9.0%)
	Junior high school	110 (25.3%)
	Senior high school/junior technical school	131 (30.2%)
	Senior technical college	80 (18.4%)
	Bachelor’s	66 (15.2%)
	Master’s or above	8 (1.8%)
Employment status	Full-time	171 (39.4%)
	Part-time	19 (4.4%)
	Retired	160 (36.9%)
	Laid-off	10 (2.3%)
	Unemployed	24 (5.5%)
	Student	14 (3.2%)
	Other	36 (8.3%)
Comorbidity	Hypertension	184 (42.4%)
	Hyperlipidemia	41 (9.4%)
	Hyperuricaemia	121 (27.9%)
	Diabetes	58 (13.4%)
	Anemia	26 (6.0%)
	Other chronic disease	226 (52.1%)

Note: “Other” means “the patient refused to disclose their social status”.

Table 2 Kaiser–Meyer–Olkin and Bartlett’s Test of Sphericity

		Statistics
KMO Measure of Sampling Adequacy		0.8
Bartlett’s Test of Sphericity	Approx. Chi-Square	1340.0
	df	105.0
	Sig.	0.0

Abbreviation: KMO, Kaiser–Meyer–Olkin.

Table 3 Total Variance Explained Using Exploratory Factor Analysis

Factor	Extraction Sums of Squared Loadings			Rotation Sums of Squared Loadings
	Total	% of Variance	Cumulative %	Total	% of Variance	Cumulative %
1	5.1	34.0	34.0	5.0	33.0	33.0
2	1.6	10.8	44.8	1.7	11.1	44.2
3	1.5	9.7	54.4	1.4	9.6	53.8
4	1.1	7.1	61.5	1.2	7.7	61.5

Table 4 Measure of Sampling Adequacy and Factor Loading

	Mean±SD	MSA	C^2	Factor Loading
				1	2		3		4
1. Do you know the therapeutic effect of each drug you are taking?	3.6±1.0	0.8	0.6	0.6	0.2		−0.2		0.5
2. Do you know how to use the medicine you are taking?	4.1±1.0	0.8	0.7	0.6	0.3		−0.2		0.6
3. Do you know what utensils should be used for Chinese medicine decoction?	4.1±1.0	0.9	0.6	0.7	0.1		0.2		0.2
4. Did you understand how to properly soak the herbal drugs before decocting?	3.7±1.2	0.8	0.6	0.8	0.1		0.3		0.1
5. Do you understand the following situations that require special handling in traditional Chinese medicine decoction process (ie which herb should be decocted first, which should be decocted later, wrap-boiling, melting, separate decoction, and infusion)?	3.5±1.2	0.9	0.6	0.8	0.0		0.1		0.0
6. Do you know the best temperature for taking traditional Chinese medicine?	3.0±1.3	0.9	0.7	0.8	−0.1		0.0		−0.1
7. Do you know the best time to take traditional Chinese medicine?	2.8±1.2	0.9	0.7	0.8	−0.0		−0.1		−0.1
8. Do you know the dosage of traditional Chinese medicine?	3.1±1.1	0.9	0.7	0.8	−0.0		0.1		−0.2
9. Do you know the dietary contraindications while taking Chinese medicine?	2.9±1.1	0.9	0.6	0.7	0.1		0.1		−0.1
10. I think the taste of traditional Chinese medicine is acceptable	3.8±0.7	0.6	0.6	0.1	0.0		0.7		0.0
11. I think there is no difficulty in decocting and taking Chinese medicine by oneself for a long time.	3.5±0.9	0.7	0.7	0.2	0.1		0.8		−0.0
12. I think it is normal to have all kinds of side effects after taking drugs.	3.0±0.7	0.6	0.6	0.2	0.2		−0.1		−0.7
13. Have you stopped taking medication at any point during the past month because you felt your symptoms had improved?	4.5±0.8	0.5	0.7	0.1	0.8		0.0		−0.0
14. Have you stopped taking medication at any point during the past month because you felt worse?	4.7±0.7	0.8	0.7	0.1	0.8		0.0		−0.2
15. Have you changed a traditional Chinese medicine prescription yourself within the past month?	4.9±0.4	0.5	0.3	−0.1	0.4		0.1		0.3

Note: The grey shading indicates items with factor loading >0.4 .

Table 5 Results of Internal Consistency

Item	Medication Adherence	Knowledge	Belief	Behavior
Cronbach’s Alpha	0.9	0.9	0.4	0.5
Spearman–Brown coefficient	0.6	0.8	0.1	0.3
Guttman coefficient	0.5	0.8	0.1	0.2
Pearson correlation coefficient	−0.8**	−0.8**	0.4*	−0.3
p value	<0.001	<0.001	0.0	0.1

Note: **p<0.01. *p<0.05.

Table 6 Association Between Patient Characteristics and e-Questionnaire Response

Characteristics		Respondent (N=228)	Nonrespondent (N=206)		P value
Age, years		(38.3, 62.0)	(35.8, 61.0)	z =−0.4	0.7
Sex	Male	114 (50%)	108 (52.4%)	Pearson x^2=0.6	0.4
	Female	114 (50%)	98 (47.6%)
Marital status	Unmarried	26 (11.4%)	31 (15.0%)	z = −1.1	0.3
	Married	198 (86.8%)	172 (83.5%)
	Other	4 (1.8%)	3 (1.5%)
SCr, μmol/L		(77.3, 146.8)	(81.0, 162.3)	z = −1.1	0.3
eGFR, mL/min/1.73 m2		(34.7, 93.1)	(35.39, 90.3)	z =−1.0	0.3
CKD stage	1	56 (24.6%)	52 (25.2%)	z = −0.3	0.8
	2	58 (25.4%)	51 (24.8%)
	3	78 (34.2%)	63 (30.6%)
	4	22 (9.6%)	24 (11.7%)
	5	14 (6.1%)	16 (7.8%)
Education level	Primary school	19 (8.3%)	20 (9.7%)	z = −0.4	0.7
	Junior high school	57 (25.0%)	53 (25.7%)
	Senior high school/junior technical school	68 (29.8%)	63 (30.6%)
	Senior technical college	48 (21.1%)	32 (15.5%)
	Bachelor’s	33 (14.5%)	33 (16.0%)
	Master’s or above	3 (1.3%)	5 (2.4%)
Working status	Full-time	95 (41.7%)	76 (36.9%)	z = −1.5	0.1
	Part-time	9 (3.9%)	10 (4.9%)
	Retired	86 (37.7%)	74 (35.9%)
	Laid-off	5 (2.2%)	5 (2.4%)
	Unemployed	14 (6.1%)	10 (4.9%)
	Student	7 (3.1%)	7 (3.4%)
	Other	12 (5.3%)	24 (11.7%)
Comorbidity	Hypertension	103 (45.2%)	81 (39.3%)	Pearson x^2=17.5	<0.001
	Hyperlipidemia	23 (10.1%)	18 (8.7%)	Pearson x^2=414.7	<0.001
	Hyperuricaemia	62 (27.2%)	59 (28.6%)	Pearson x^2=129.2	<0.001
	Diabetes	25 (11.0%)	33 (16.0%)	Pearson x^2=347.0	<0.001
	Anemia	11 (4.8%)	15 (7.3%)	Pearson x^2=506.1	<0.001
	Other chronic disease	122 (53.5%)	104 (50.5%)	Pearson x^2=56.2	<0.001