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Self-reported measures with scoring methods were included. Studies without proxy measures were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>Using detailed searches with key concepts including questionnaires, reliability and validity, and restricted to English, MEDLINE, EMBASE, CINAHL, International Pharmaceutical Abstracts, and Cochrane Library were searched until 01 March 2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA-2020) checklist was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data analysis<\/jats:title>\n                    <jats:p>Risk of bias was assessed via COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN-2018) guidelines. Narrative synthesis aided by graphical figures and statistical analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Process domains [behaviour (e.g., self-efficacy), barrier (e.g., impaired dexterity) or belief (e.g., perception)], and overall outcome domains of either intentional (I), unintentional (UI), or mixed non-adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Paper summarises evidence from 59 studies of PROMs, validated among patients aged 18\u201388 years in America, the United Kingdom, Europe, Middle East, and Australasia. PROMs detected outcome domains: intentional non-adherence, n=44 (I=491 criterion items), mixed intentionality, n=13 (I=79\/UI=50), and unintentional, n=2 (UI=5). Process domains detected include belief (383 criterion items), barrier (192) and behaviour (165). Criterion validity assessment used proxy measures (biomarkers, e-monitors), and scoring was ordinal, dichotomised, or used Visual Analogue Scale. Heterogeneity was revealed across psychometric properties (consistency, construct, reliability, discrimination ability). Intentionality correlated positively with negative beliefs (r(57)=0.88) and barriers (r(57)=0.59). For every belief or barrier criterion-item, PROMs\u2019 aptitude to detect intentional non-adherence increased by \u03b2=0.79 and \u03b2=0.34 units, respectively (R\n                      <jats:sup>2<\/jats:sup>\n                      =0.94). Primary care versus specialised care predicted intentional non-adherence (OR 1.9; CI 1.01 to 2.66).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Ten PROMs had\n                      <jats:italic>adequate<\/jats:italic>\n                      psychometric properties. Of the ten, eight PROMs were able to detect total, and two PROMs were able to detect partial intentionality to medication default. Fortification of patients\u2019 knowledge and illness perception, as opposed to daily reminders alone, is most imperative at primary care levels.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-057868","type":"journal-article","created":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T13:06:21Z","timestamp":1663592781000},"page":"e057868","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Patient-reported outcome measures to detect intentional, mixed, or unintentional non-adherence to medication: a systematic review"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9042-4290","authenticated-orcid":false,"given":"Mathumalar Loganathan","family":"Fahrni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamaliah Md","family":"Saman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Saleh","family":"Alkhoshaiban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faiza","family":"Naimat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6861-2324","authenticated-orcid":false,"given":"Farzan","family":"Ramzan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6249-6476","authenticated-orcid":false,"given":"Khairil Anuar Md","family":"Isa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,9,19]]},"reference":[{"key":"2022091910051272000_12.9.e057868.1","doi-asserted-by":"crossref","DOI":"10.15585\/mmwr.mm6645a2","article-title":"CDC Grand Rounds: Improving Medication Adherence for Chronic Disease Management - Innovations and Opportunities","volume":"66","author":"Neiman","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022091910051272000_12.9.e057868.2","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1007\/s40620-020-00895-x","article-title":"Medication non-adherence in chronic kidney disease: a mixed-methods review and synthesis using the theoretical domains framework and the behavioural change wheel","volume":"34","author":"Tesfaye","year":"2021","journal-title":"J Nephrol"},{"key":"2022091910051272000_12.9.e057868.3","doi-asserted-by":"crossref","DOI":"10.2196\/23294","article-title":"Acceptability of the medication event reminder monitor for promoting adherence to multidrug-resistant tuberculosis therapy in two Indian cities: qualitative study of patients and health care providers","volume":"23","author":"Thomas","year":"2021","journal-title":"J Med Internet Res"},{"key":"2022091910051272000_12.9.e057868.4","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1111\/1754-9485.13048","article-title":"Using patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs) in routine head and neck cancer care: what do health professionals perceive as barriers and facilitators?","volume":"64","author":"Nguyen","year":"2020","journal-title":"J Med Imaging Radiat Oncol"},{"key":"2022091910051272000_12.9.e057868.5","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-198601000-00007"},{"key":"2022091910051272000_12.9.e057868.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0738-3991(98)00107-4"},{"key":"2022091910051272000_12.9.e057868.7","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06081-4"},{"key":"2022091910051272000_12.9.e057868.8","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-12-1"},{"key":"2022091910051272000_12.9.e057868.9","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01626-4"},{"key":"2022091910051272000_12.9.e057868.10","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-017-1765-4"},{"key":"2022091910051272000_12.9.e057868.11","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-009-9528-5"},{"key":"2022091910051272000_12.9.e057868.12","doi-asserted-by":"publisher","DOI":"10.1891\/rtnp.16.3.179.53008"},{"key":"2022091910051272000_12.9.e057868.13","doi-asserted-by":"publisher","DOI":"10.1177\/109019817400200403"},{"key":"2022091910051272000_12.9.e057868.14","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700050182"},{"key":"2022091910051272000_12.9.e057868.15","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.12.1607"},{"key":"2022091910051272000_12.9.e057868.16","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/S0161-6420(97)30314-5","article-title":"Validation of a questionnaire for comparing the tolerability of ophthalmic medications","volume":"104","author":"Barber","year":"1997","journal-title":"Ophthalmology"},{"key":"2022091910051272000_12.9.e057868.17","unstructured":"Horne R , Weinman J . 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