title: Clinical cutoffs for adherence barriers in solid organ transplant recipients: how many is too many?
abstract: OBJECTIVE
  The current study used multiple statistical methods to determine empirically derived and clinically relevant cutoff scores on the Adolescent Medication Barriers Scale (AMBS) and Parent Medication Barriers Scale (PMBS) to detect adolescents and young adults with solid organ transplants who experienced medication nonadherence or negative medical outcomes.
  
  
  METHODS
  Participants included 71 patients and 80 caregivers. Cutoff scores were determined via receiver operating characteristic curve analyses, t-test analyses, and the sensitivity and specificity of using certain cutoff scores.
  
  
  RESULTS
  AMBS scores of ≥3 barriers and PMBS scores of ≥2 barriers were determined as the ideal cutoffs for identifying patients meeting criteria for the outcome variables.
  
  
  CONCLUSIONS
  Clinicians should consider using these recommended cutoff scores when assessing adherence barriers in adolescents and young adults with solid organ transplants and their families. Patients or caregivers endorsing barriers above the cutoffs may benefit from further assessment or intervention to address barriers, nonadherence, or related medical issues.
authors.affiliation: University of Georgia, Boston Children's Hospital/Harvard Medical School, Rutgers Cancer Institute of New Jersey, and Children's Healthcare of Atlanta/Emory University School of Medicine cydeaton@uga.edu.
authors.forename: Cyd K
authors.initials: CK
authors.lastname: Eaton
authors.affiliation: University of Georgia, Boston Children's Hospital/Harvard Medical School, Rutgers Cancer Institute of New Jersey, and Children's Healthcare of Atlanta/Emory University School of Medicine.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Lee
authors.affiliation: University of Georgia, Boston Children's Hospital/Harvard Medical School, Rutgers Cancer Institute of New Jersey, and Children's Healthcare of Atlanta/Emory University School of Medicine.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Simons
authors.affiliation: University of Georgia, Boston Children's Hospital/Harvard Medical School, Rutgers Cancer Institute of New Jersey, and Children's Healthcare of Atlanta/Emory University School of Medicine.
authors.forename: Katie A
authors.initials: KA
authors.lastname: Devine
authors.affiliation: University of Georgia, Boston Children's Hospital/Harvard Medical School, Rutgers Cancer Institute of New Jersey, and Children's Healthcare of Atlanta/Emory University School of Medicine.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Mee
authors.affiliation: University of Georgia, Boston Children's Hospital/Harvard Medical School, Rutgers Cancer Institute of New Jersey, and Children's Healthcare of Atlanta/Emory University School of Medicine.
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Blount
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D010290:Parents / Q000523:psychology; D012372:ROC Curve; D012189:Retrospective Studies; D066027:Transplant Recipients / Q000523:psychology*; D055815:Young Adult
keywords: adherence; barriers; pediatric; transplant