title: Long-term treatment acceptance: what is it, and how can it be assessed?
abstract: BACKGROUND
  Understanding the link between patients' beliefs and behavior may help explain their attitude to their treatment. How patients' personal experience of their treatment results in their decision to accept taking it or not and to persist in taking it remains to be explored more thoroughly. Acceptance is hypothesized to be the balance patients establish between their medication's advantages and its disadvantages, based on their personal experience with the medication. Measuring patients' acceptance of their medication is likely to predict their behavior (adherence and persistence) towards their treatment.
  
  
  OBJECTIVE
  Our objective was to develop a generic medication acceptance measure assessing how patients weigh advantages and disadvantages of long-term medications.
  
  
  METHODS
  A literature review was conducted using keywords related to acceptance, perceptions, motivations, and barriers linked to treatment. Exploratory interviews were performed with five pharmacists and 19 patients. Interviews were systematically analyzed in order to complete the initial conceptual model. Questionnaire items were generated for each concept identified, using patients' words. The resulting test version was tested for relevance and comprehension with six patients and revised accordingly; the new version was tested on a second set of five patients and revised to create the pilot version of the questionnaire.
  
  
  RESULTS
  Items generated for each concept identified were organized into six domains: drug characteristics, duration, constraints, side effects, efficacy, and global acceptance of treatment. Except for a few items that were modified or deleted following patients' suggestions and some minor modifications in the answer choices, the questionnaire was globally well accepted, easy to complete, and considered relevant and appropriate by patients. The pilot version of the ACCEPT© questionnaire contains 32 questions divided into the same six domains as the test version.
  
  
  CONCLUSIONS
  The existence of the hypothesized concept of medication acceptance was confirmed. The ACCEPT© questionnaire will allow assessment of the acceptance of a wide range of long-term medications based on patient experience. Further study will examine how well this measure predicts and explains adherence to these medications.
authors.affiliation: MAPI Consultancy, Lyon, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Marant
authors.forename: Juliette
authors.initials: J
authors.lastname: Longin
authors.forename: Rémi
authors.initials: R
authors.lastname: Gauchoux
authors.forename: Benoit
authors.initials: B
authors.lastname: Arnould
authors.forename: Céderic
authors.initials: C
authors.lastname: Spizak
authors.forename: Alexia
authors.initials: A
authors.lastname: Marrel
authors.forename: Donald L
authors.initials: DL
authors.lastname: Patrick
authors.forename: Eric
authors.initials: E
authors.lastname: Van Ganse
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008134:Long-Term Care / Q000523:psychology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010595:Pharmacists; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors