The ACCEPT questionnaire is a generic measure of treatment Acceptance. ACCEPT captures the patient attitudes toward their medical treatment and their motivation to adhere to it in the long-term.
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Introduction
“Adherence to long-term therapy for chronic illnesses in developed countries averages 50%. In developing countries, the rates are even lower. It is undeniable that many patients experience difficulty in following treatment recommendations.”
2003 World Health Organization report
With about half of adults suffering from at least one chronic disease in developed countries, it is essential to improve patient adherence to prescribed treatments. The WHO underlines that adherence is a complex and dynamic process, subject to change according to the life circumstances of the patient. Adherence can be influenced by a numerous factors:
- patient-related factors (self-efficacy, knowledge and understanding of disease risks, expectations and beliefs about medications)
- therapy-related factors (efficacy, perceived benefits, side effects)
- condition-related factors (duration, severity, complications)
- healthcare system-related factors (access to healthcare, availability of healthcare providers) and the quality of the relationship between the patient and the healthcare provider.
ADHERENCE TO LONG-TERM THERAPY FOR CHRONIC ILLNESSES IN DEVELOPED COUNTRIES AVERAGES ONLY 50%
Mode of Use, Scoring, and Interpretation
ACCEPT, a patient questionnaire with 25 items, evaluates the patient’s acceptance of long-term treatment in real life. It assesses the current general level of treatment acceptance, which can be interpreted as an individualized assessment of Risk/Benefit ratio. In a recent large European study, this general level of acceptance ranged from 33 (low acceptance) for Fibromyalgia patients to 66 (high acceptance) for Type 1 diabetes patients, on a 0-100 acceptance scale (0 = lowest acceptance; 100=highest acceptance). The detailed contents of the items shed light on the various factors determining this level of acceptance and likely to impact adherence and persistence: it includes clinical factors such as perceived efficacy and tolerability, as well as non-clinical factors such as time horizon, poly-medication, frequency, and other practical features.
The very simple answer pattern allows rapid completion by patients (less than 10 minutes for 50% of patients at first completion), as well as easy and direct interpretation at item level: eg 32% of Type 2 diabetes patients receiving insulin or analogs find the storage conditions for journey “not easy to accept”. In addition to the interpretation at the item-level, factors determining level of general acceptance are summarized in 5 dimensions scored 0-100 (0=lowest acceptance; 100=highest accceptance): Acceptance/Medication Inconvenience; Acceptance/Long-term Treatement; Acceptance/Regimen Constraints; Acceptance/Side Effects; Acceptance/Effectiveness.
DATA FROM THE ACCEPT QUESTIONNAIRE CAN ALSO HELP IDENTIFY UNMET NEEDS AND GREATER OPPORTUNITIES FOR ADHERENCE PROGRESS
Conditions of use and available translations
The ACCEPT is distributed by Mapi Research Trust on behalf of its copyright holder, Mapi.
Mapi Research Trust is a non-profit organization dedicated to improving patients’ quality of life by facilitating access to Patient-Centered Outcome (PCO) information by centralizing information. Please visit our website for more information. mapi-trust.org
Any questions on the ACCEPT, on its conditions of use, its available translations shall be directed to Mapi Research Trust.
Please submit your request directly into our ePROVIDE™ database and our PROVIDE™ team will get back to you as soon as possible.
The list of existing and available translations of the ACCEPT is available on ePROVIDE™
Author
Benoit Arnould, PhD
Senior Director, Global, Patient-Centered Outcomes, Mapi
Dr. Benoit Arnould has been conducting studies to develop and validate Patient-Reported Outcome (PRO) measures for 2 decades.
In recent years, Benoit has increasingly been asked by Industry clients to assist in their endpoint strategy definition. Benoit has sound knowledge of clinical and epidemiological trial design, data analysis and interpretation. Benoit is a Health Economics graduate with a speciality in statistics, and has completed, under the supervision of Professor Gerard Duru, his PhD on tools for clinical decision making, a subject on which he publishes regularly.
ACCEPT IS AVAILABLE FOR ACADEMIC AND INDUSTRY SPONSORED RESEARCH. ACCEPT DATA FROM OUR APTEO SURVEYS (MORE THAN 11,000 EUROPEAN PATIENTS) AVAILABLE FOR TAILORED ANALYSES.
References
Arnould B. Did you get why patients accept (or not) their long-term treatment? Results from an EU study via Carenity social platform. Presented at: DIA 2017 Annual Meeting; June 22, 2017; Chicago, IL, USA.
Arnould B, Gilet H, Patrick DL, Acquadro C. Item reduction, scoring, and first validation of the ACCEPTance by the patients of their treatment (ACCEPT©) questionnaire. Patient. 2017; 10(1):81-92.
de Bock E, Chekroun M, Morisky DE, Arnould B. Patients’ acceptance and adherence of their medication: results from an European multi-disease study with online patient community. Value Health. 2016 Nov;19(7):A477. Presented at: ISPOR 19th Annual European Congress; October 31, 2016; Vienna, Austria.
Gilet H, Chekroun M, Arnould B. Workshop: How can patient online communities inform industry about barriers to medication acceptance and unmet needs? Lessons learned from a French multi-disease study using a patient online community. Presented at: ISPOR 17th Annual European Congress; November 12, 2014; Amsterdam, The Netherlands.
Bourhis Y, Chretin S, Cantarovich D, Gilet H, Bugnard F, Arnould B. Accept© questionnaire: relation between acceptance and compliance in liver- and kidney-transplanted patients converted to once-daily tacrolimus. Value Health. 2014 Nov;17(7):A471. Presented at: ISPOR 17th Annual European Congress; November 10, 2014; Amsterdam, The Netherlands.
Gilet H, Chekroun M, Arnould B. Patients’ acceptance of their medication: results from a French multi-diseases study with patient online community using the acceptance by the patients of their treatment (ACCEPT©) questionnaire. Value Health. 2014 Nov;17(7):A512-A513. Presented at: ISPOR 17th Annual European Congress; November 8, 2014; Amsterdam, The Netherlands.
Arnould B, Gauchoux R, Meunier J, Gilet H, Regnault A. Validation of ACCEPT®, a new generic measure to assess how patients with chronic diseases balance between the advantages and disadvantages of following the recommended treatment regimen in real-life. Value Health. 2013 Nov;16(7):A335. Presented at: ISPOR 16th Annual European Congress; November 2, 2013; Dublin, Ireland.
Marant C, Longin J, Gauchoux R, Arnould B, Spizak C, Marrel A, et al. Long-term treatment acceptance: what is it and how can it be assessed? Patient. 2012;5(4):239-49.
Dias-Barbosa C, Gauchoux R, Arnould B, Patrick D, van Ganse E. Acceptability of long-term treatment: what is it, and how can it be assessed. European Society for Patient Adherence, COMpliance, and Persistence (ESPACOMP) 15th Annual Meeting; 2011; Utrecht, The Netherlands.
Chretin S, Viala-Danten M, Van Ganse E, Patrick D, Arnould B, Longin J. The missing piece between treatment experience and intention to persist: testing the internal consistency reliability and predictive validity of acceptability. Value Health. 2010 Nov;13(7):A361. Presented at: ISPOR 13th Annual European Congress; November 8, 2010; Prague, Czech Republic.
Marant C, Spizak C, Longin J, Marrel A, Van Ganse E, Arnould B, et al. Development of the ACCEPT© questionnaire to assess acceptability of long term treatments: qualitative steps. Value Health. 2009 Oct;12(7):A400. Presented at: ISPOR 12th Annual European Congress; October 27, 2009; Paris, France.
Saussier C, van Ganse E, Augé-Caumont MJ, Chamba G, Marrel A, Benmedjahed K, et al. The contribution of the measurement of treatment acceptability to understand patients’ adherence to long-term treatments. Results from a feasability study conducted with in Fine Pharma, a community-pharmacy network dedicated to pharmacoepidemiological surveys. Value Health. 2008 Nov:11(6): A409. Presented at: ISPOR 11th Annual European Congress; November 11, 2008; Athens, Greece.
Marant C, Longin J, Spizak C, Patrick DL, Saussier C, Arnould B, et al. What does acceptability mean for patients and how should it be measured? Qualitative steps for the development of a new measurement instrument in pharmacies. Value Health. 2008 Nov;11(6):A571. Presented at: ISPOR 11th Annual European Congress; November 11, 2008; Athens, Greece.
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