ASK-20^SM is a valid and reliable self-administered survey for patients that can identify 20 specific, actionable barriers to medication adherence across a spectrum of chronic diseases.

Development of the ASK-20^SM Survey¹

• The survey was developed from clinician opinion (MDs and RNs), patient focus groups, and literature review.
• The initial pool of 47 items addressed a comprehensive range of adherence barrier categories, including Lifestyle, Attitudes and Beliefs, Help From Others, Talking With Healthcare Team, and Taking Medicines.
• In a study of 605 randomly selected patients with asthma, diabetes, or depression, the face and content validity of the survey were determined.
• Survey item reduction to 20 items was based on clinical and statistical review.
• Readability level of the items was =6th grade.

Prevalence of Barriers²

• Barriers in the Lifestyle and Taking Medicines categories were found to be the most significant predictors of suboptimal adherence in patients with asthma, depression, or diabetes.
• The average number of barriers detected by ASK-20^SM in patients with asthma, diabetes, or depression was 4.2.
• Patients with diabetes reported fewer total barriers (3.2) than those with depression (4.4) or asthma (5.1, P<0.0001).

Validation of ASK-20^{SM 3}

• ASK-20^SM demonstrated adequate reliability, criterion validity, and discriminant validity in a sample of 112 patients with asthma or type 2 diabetes.
• The 20-item scale demonstrated good internal consistency (Cronbach's alpha = 0.77) and test-retest reliability (ICC = 0.80).
• Construct validity was demonstrated through significant correlations with previously validated measures of treatment adherence and health-related quality of life.

References:

1. Hahn SR et al. Development of the ASK-20 adherence barrier survey. Curr Med Res Opin. 2008; 24 (7):2127-2138.
2. Hahn SR, Yu-Isenberg KS, Priest JL, Skinner EP, Weaver MB, Olson PS. A comparison of barriers to medication adherence in patients with chronic conditions. Poster presented at: Society of General Internal Medicine 29th Annual Meeting; April 26-29, 2006; Los Angeles, California.
3. Matza L et al. Further testing of the reliability and validity of the ASK-20 adherence barrier questionnaire in a medical center outpatient population. Curr Med Res Opin. 2008; 24 (11):3197-3206.