Alfredo Dias de Oliveira-Filho1, Donald E Morisky2, Sabrina Joany Felizardo Neves3, Francisco A Costa4, Divaldo Pereira de Lyra5. 1. Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, Sergipe, Brazil; School of Nursery and Pharmacy (ESENFAR), Federal University of Alagoas, Alagoas, Brazil. 2. University of California Los Angeles, School of Public Health, Los Angeles, CA, USA. 3. School of Nursery and Pharmacy (ESENFAR), Federal University of Alagoas, Alagoas, Brazil. 4. Hospital do Açúcar, Alagoas, Brazil. 5. Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, Sergipe, Brazil. Electronic address: lyra_jr@hotmail.com.
Abstract
BACKGROUND: The Morisky Medication Adherence Scale (MMAS-8) remains one of the most widely used mechanisms to assess patient adherence. Its translation and testing on languages in addition to English would be very useful in research and in practice. OBJECTIVE: To translate and examine the psychometric properties of the Portuguese version of the structured self-report eight-item Morisky Medication Adherence Scale among patients with hypertension. METHODS: The study was designed as a cross-sectional survey conducted in six Family Health Units of the Brazilian Unified Health System, in Maceió, between March 2011 and April 2012. After a standard "forward-backward" procedure to translate MMAS-8 into Portuguese, the questionnaire was applied to 937 patients with hypertension. Reliability was tested using a measure of internal consistency (Cronbach's alpha), and test-retest reliability. Validity was confirmed using known groups validity. Three levels of adherence were considered based on the following scores: 0 to <6 (low); 6 to <8 (medium); 8 (high). RESULTS: The mean age of respondents was 57.1 years (SD = 12.7 years), and 71.5% were female. The mean number of prescribed antihypertensives per patient was 1.62 (SD = 0.67). The mean score for the medication adherence scale was 5.78 (SD = 1.88). Moderate internal consistency was found (Cronbach's alpha = 0.682), and test-retest reliability was satisfactory (Spearman's r = 0.928; P < 0.001). A significant relationship between MMAS-8 levels of adherence and BP control (chi-square, 8.281; P = 0.016) was found. 46.0%, 33.6%, and 20.4% of patients had low, medium, and high adherence, respectively. The self-report measure sensitivity, specificity, positive and negative predictive values were 86.1%, 31.2%, 57.4% and 68.3% respectively. CONCLUSIONS: Psychometric evaluation of the Portuguese version of the MMAS-8 indicates that it is a reliable and valid measure to detect patients at risk of non-adherence. The MMAS-8 could still be used in routine care to support communication about the medication-taking behavior in hypertensive patients.
BACKGROUND: The Morisky Medication Adherence Scale (MMAS-8) remains one of the most widely used mechanisms to assess patient adherence. Its translation and testing on languages in addition to English would be very useful in research and in practice. OBJECTIVE: To translate and examine the psychometric properties of the Portuguese version of the structured self-report eight-item Morisky Medication Adherence Scale among patients with hypertension. METHODS: The study was designed as a cross-sectional survey conducted in six Family Health Units of the Brazilian Unified Health System, in Maceió, between March 2011 and April 2012. After a standard "forward-backward" procedure to translate MMAS-8 into Portuguese, the questionnaire was applied to 937 patients with hypertension. Reliability was tested using a measure of internal consistency (Cronbach's alpha), and test-retest reliability. Validity was confirmed using known groups validity. Three levels of adherence were considered based on the following scores: 0 to <6 (low); 6 to <8 (medium); 8 (high). RESULTS: The mean age of respondents was 57.1 years (SD = 12.7 years), and 71.5% were female. The mean number of prescribed antihypertensives per patient was 1.62 (SD = 0.67). The mean score for the medication adherence scale was 5.78 (SD = 1.88). Moderate internal consistency was found (Cronbach's alpha = 0.682), and test-retest reliability was satisfactory (Spearman's r = 0.928; P < 0.001). A significant relationship between MMAS-8 levels of adherence and BP control (chi-square, 8.281; P = 0.016) was found. 46.0%, 33.6%, and 20.4% of patients had low, medium, and high adherence, respectively. The self-report measure sensitivity, specificity, positive and negative predictive values were 86.1%, 31.2%, 57.4% and 68.3% respectively. CONCLUSIONS: Psychometric evaluation of the Portuguese version of the MMAS-8 indicates that it is a reliable and valid measure to detect patients at risk of non-adherence. The MMAS-8 could still be used in routine care to support communication about the medication-taking behavior in hypertensivepatients.
Authors: Walter Espeche; Martin R Salazar; Rodrigo Sabio; Alejandro Diaz; Carlos Leiva Sisnieguez; Daniel Olano; Eduardo Balbin; Nicolas Renna; Pedro Grosse; Roberto A Flores; Ana C Lagos; Pablo Ferrer; Silvia Poppe; Facundo Risso Patron; Victor D Sotnieczuk Stasiuk; Elina Valentini; Jose R Cardozo; Jose R Romano; Roberto Parodi; Horacio Carbajal Journal: J Clin Hypertens (Greenwich) Date: 2020-02-17 Impact factor: 3.738