Portal de Periódicos da CAPES

Construction, internal validation and implementation in a mobile application of a scoring system to predict nonadherence to proton pump inhibitors

2017; PeerJ, Inc.; Volume: 5; Linguagem: Inglês

10.7717/peerj.3455

2167-8359

Emma Mares‐García, Antonio Palazón‐Bru, David Manuel Folgado-de la Rosa, Avelino Pereira-Expósito, Álvaro Martínez-Martín, Ernesto Cortés‐Castell, Vicente Gil-Guillén,

Medication Adherence and Compliance

Other studies have assessed nonadherence to proton pump inhibitors (PPIs), but none has developed a screening test for its detection.To construct and internally validate a predictive model for nonadherence to PPIs.This prospective observational study with a one-month follow-up was carried out in 2013 in Spain, and included 302 patients with a prescription for PPIs. The primary variable was nonadherence to PPIs (pill count). Secondary variables were gender, age, antidepressants, type of PPI, non-guideline-recommended prescription (NGRP) of PPIs, and total number of drugs. With the secondary variables, a binary logistic regression model to predict nonadherence was constructed and adapted to a points system. The ROC curve, with its area (AUC), was calculated and the optimal cut-off point was established. The points system was internally validated through 1,000 bootstrap samples and implemented in a mobile application (Android).The points system had three prognostic variables: total number of drugs, NGRP of PPIs, and antidepressants. The AUC was 0.87 (95% CI [0.83-0.91], p < 0.001). The test yielded a sensitivity of 0.80 (95% CI [0.70-0.87]) and a specificity of 0.82 (95% CI [0.76-0.87]). The three parameters were very similar in the bootstrap validation.A points system to predict nonadherence to PPIs has been constructed, internally validated and implemented in a mobile application. Provided similar results are obtained in external validation studies, we will have a screening tool to detect nonadherence to PPIs.