title: Reliability and validity of an instrument for assessing patients' perceptions about medications for diabetes: the PAM-D.
abstract: OBJECTIVE
  To evaluate the reliability and validity of the Perceptions About Medications for Diabetes (PAM-D) instrument.
  
  
  METHODS
  The item pool was generated from a literature review and 18 focus groups of Type 2 diabetes patients. Surveys were mailed to 1,000 low-income diabetes patients; 362 were returned; 65 of 100 re-test surveys were returned.
  
  
  RESULTS
  This paper uses data from 343 Type 2 respondents. Mean age and age diagnosed were 59 and 48, respectively; 72% female; 52% African American; 51% were taking oral antihyperglycemic agents [OHA] monotherapy, 18% insulin monotherapy, and 28% insulin plus OHA. The initial 66 items were reduced to 37 across nine scales: scheduling flexibility, portability convenience, regimen inconvenience, medication effectiveness, difficulty remembering medications, gastrointestinal, hypoglycemia-related, and weight/edema physical side effects, and emotional side effects. Scale reliabilities ranged from 0.71 to 0.92 (coefficient alpha) and from 0.54 to 0.83 (test-retest coefficient, 37-81-day interval); factor loadings ranged from 0.35 to 0.86 (median, 0.67); significant scale differences across medication groups (insulin, OHA, insulin plus OHA) were consistent with a priori hypotheses.
  
  
  CONCLUSIONS
  The PAM-D has substantial reliability and validity in a low-income, inner-city population of Type 2 diabetes patients and may be valuable for understanding multidimensional perceptions driving patients' treatment preferences.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202-3012, USA. pmonahan@iupui.edu
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Monahan
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Lane
authors.forename: Risa P
authors.initials: RP
authors.lastname: Hayes
authors.forename: Colleen A
authors.initials: CA
authors.lastname: McHorney
authors.forename: David G
authors.initials: DG
authors.lastname: Marrero
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin