A validated measure of adherence to antibiotic prophylaxis in children with sickle cell disease

Natalie A. Duncan, William G. Kronenberger, Kisha C. Hampton, Ellen M. Bloom, Angeli G. Rampersad, Christopher P. Roberson, Amy D. Shapiro

Research output: Contribution to journalArticle

3 Scopus citations


Background: Antibiotic prophylaxis is a mainstay in sickle cell disease management. However, adherence is estimated at only 66%. This study aimed to develop and validate a Sickle Cell Antibiotic Adherence Level Evaluation (SCAALE) to promote systematic and detailed adherence evaluation. Methods: A 28-item questionnaire was created, covering seven adherence areas. General Adherence Ratings from the parent and one health care provider and medication possession ratios were obtained as validation measures. Results: Internal consistency was very good to excellent for the total SCAALE (α=0.89) and four of the seven subscales. Correlations between SCAALE scores and validation measures were strong for the total SCAALE and five of the seven subscales. Conclusion: The SCAALE provides a detailed, quantitative, multidimensional, and global measurement of adherence and can promote clinical care and research.

Original languageEnglish (US)
Pages (from-to)983-992
Number of pages10
JournalPatient Preference and Adherence
StatePublished - Jun 8 2016



  • Compliance
  • Hemoglobinopathy
  • Newborn screening program
  • Penicillin prophylaxis
  • Sickle SAFE program

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Social Sciences (miscellaneous)
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Health Policy

Cite this

Duncan, N. A., Kronenberger, W. G., Hampton, K. C., Bloom, E. M., Rampersad, A. G., Roberson, C. P., & Shapiro, A. D. (2016). A validated measure of adherence to antibiotic prophylaxis in children with sickle cell disease. Patient Preference and Adherence, 10, 983-992. https://doi.org/10.2147/PPA.S103874