PhD Defense of Audrey Lehmann on 12/14/20

PhD Defense of Audrey Lehmann from TIMC ThEMAS and LIP/PC2S, Laboratoire Inter-universitaire de Psychologie, on december, the 14th at 2pm:

« How to qualify medication adherence difficulties :
new taxonomy in french and construction of a screening tool. »


Place : CHU Grenoble Alpes (jury only)

Thesis supervision:

  • Benoît Allenet, Professeur des Universités - Praticien Hospitalier, Université Grenoble Alpes, laboratoire TIMC, Director
  • Aurélie Gauchet, Maîtresse de Conférences, Université Grenoble Alpes, laboratoire LIP/PC2S, Codirector

Jury : 

  • Catherine Tourette-Turgis, Professeur des Universités Sorbonne Université - Paris, Reporter
  • Stéphane Honoré, Professeur des Universités - Praticien Hospitalier, Aix-Marseille Université, Reporter
  • Eric Van Ganse, Maître de Conférences Universitaire - Praticien Hospitalier, Université Lyon 1, Examiner
  • Marie-Paule Schneider Voirol, Professeur, Université de Genève – Suisse, Examiner
  • Olivier Desrichard, Professeur Associé, Université de Genève – Suisse, Examiner

bullet Key words:

medication adherence, self-report measure, chronic disease, taxonomy

bullet Abstract:

The evolution of chronic diseases implies the consideration of the patient to be active and collaborative in the multidisciplinary healthcare team. Medication non-adherence is a silent epidemic that affects 50% of patients with chronic disease.
A first publication reports on the work done using the Delphi method with French-speaking members of the International Society for Medication Adherence (ESPACOMP) for the translation of the 7 terms and definitions of the ABC taxonomy of medication adherence. The objective is to promote a standardized taxonomy of medication adherence among French-speaking researchers and clinicians. Medication adherence, which describes medication-taking behavior, is defined according to three operational and quantifiable parameters: A. initiation, B. implementation, and C. Persistence.
A second publication reports a review on measures of medication adherence in chronic patients commonly used in current practice, in research projects, for epidemiological or interventional studies. For each method, the review presents descriptions of the measures and their strengths and limitations.
A third publication presents the construction of a self-questionnaire to meet our needs for the provision of a clinical routine tool (simple, self-administered, feasible in current practice, including outpatient), to target patients in difficulty with their drug treatment and to identify levers that can be mobilized for educational support.
The questionnaire was developed for a population of chronic patients with type 2 diabetes, heart failure or chronic obstructive pulmonary disease. After item generation and the item reduction phase, the QUILAM questionnaire contains a visual analogue scale and 14 likert type items. This is the first scale available in French to identify the barriers and levers of medication adherence in patients with chronic disease. Four dimensions are described: general representations, specific representations, organization and relationship with caregivers. It is relatively simple and easily integrated into the clinical routine with a good acceptability and a 5 to 10 minutes passation time. The test-retest reports a good intra-class correlation between J0 and J15 for each item.
Further research is needed to finalize the psychometric validation of the questionnaire (structural validity, internal consistency, external consistency and sensitivity following an intervention).
This tool will be used to open communication with the patient about the daily challenge of taking medication. After identification of patients at risk, several types of interventions integrated into care can be considered by multidisciplinary team working around the chronically ill patient according to the barriers and levers to medication adherence identified.