title: Assessing historical compliance with medical recommendations among transplant candidates: preliminary findings.
abstract: BACKGROUND
  Noncompliance with medical recommendations by transplant candidates and recipients carries serious consequences for morbidity and mortality. Few patient-specific, objective measures for assessing historical compliance exist.
  
  
  OBJECTIVE
  To address this gap, a psychometric and exploratory analysis of an interview-based, global measure of clinician-rated judgment of historical compliance was undertaken.
  
  
  METHODS
  All findings are based on a retrospective chart review of the medical and psychosocial evaluations of 96 consecutive potential heart transplant candidates seen at a large Southeastern academic medical center.
  
  
  RESULTS
  Preliminary results demonstrated adequate interrater reliability and discriminant validity for the measure. Additionally, results from hierarchical multivariable regression analysis revealed years of education to be positively associated with clinician-rated judgment of historical compliance.
  
  
  CONCLUSIONS
  This study provides preliminary psychometric support for the use of a measure of historical compliance among heart transplant candidates. Findings from this study also are consistent with the literature to date and may be reflective of a psychobiological process that mediates the relationship between socioeconomic status and health outcomes.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, 1-South, PO Box 250861, Charleston, SC 29425, USA. madana@musc.edu
authors.forename: Alok
authors.initials: A
authors.lastname: Madan
authors.forename: Connie
authors.initials: C
authors.lastname: White-Williams
authors.forename: Jeffery J
authors.initials: JJ
authors.lastname: Borckardt
authors.forename: Barry K
authors.initials: BK
authors.lastname: Rayburn
authors.forename: Beverly A
authors.initials: BA
authors.lastname: Bush
authors.forename: A Hal
authors.initials: AH
authors.lastname: Thurstin
mesh_terms: D000223:Adaptation, Psychological; D000407:Alabama; D002983:Clinical Competence; D003661:Decision Support Techniques; D016002:Discriminant Analysis; D004522:Educational Status; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000523:psychology / Q000628:therapy; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic / Q000379:methods* / Q000592:standards; D007600:Judgment; D016018:Least-Squares Analysis; D008297:Male; D008487:Medical History Taking / Q000379:methods* / Q000592:standards; D008499:Medical Records; D008875:Middle Aged; D015999:Multivariate Analysis; D015588:Observer Variation; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D018579:Patient Selection; D010555:Personality Inventory; D011594:Psychometrics; D012189:Retrospective Studies