New patient-reported outcome measure to assess perceived barriers to antiretroviral therapy adherence: the PEDIA scale

The present study developed and evaluated a new patient-reported outcome measure to assess perceived barriers to antiretroviral therapy (ART) adherence. 

It developed The Perceived Barriers to Antiretroviral Therapy Adherence (PEDIA) scale based on individual interviews with patients.

Pilot testing and content analysis led to the development of a 40-item version of the scale. The study applied PEDIA to 415 HIV-infected adults receiving ART for a maximum of 180 days, recruited from three healthcare facilities. 

The study included exploratory factor analysis, internal consistency, item response theory, temporal stability, and predictive test-criterion relationship for the analysis. The scale's final version contained 18 items distributed in three dimensions, like cognitive and routine problems (4 items), medication and health concerns (6 items), and patients' fears and feelings (8 items). 

The results of McDonald's omega and temporal stability showed internal consistency and stable scores by PEDIA over time. The assessment of the information's functions indicated that the three dimensions were informative for assessing a broad range of latent traits. Evidence concerning the test-criterion relationship validated the ability of PEDIA to predict non-adherence three months later. 

This study shows that PEDIA is a psychometrically adequate tool for evaluating perceived barriers in adult patients initiating ART. It can be employed both in research as well as clinical practice for the early detection of patients at risk of non-adherence and for the identification of potentially modifiable barriers.

Almeida-Brasil CC, Nascimento ED, Silveira MR, Bonolo PF, Ceccato MDGB. New patient-reported outcome measure to assess perceived barriers to antiretroviral therapy adherence: the PEDIA scale. Cad Saude Publica. 2019;35(5):e00184218. doi: 10.1590/0102-311x00184218. Epub 2019 Jun 3. PMID: 31166419.