scholarly journals Self-reported Morisky 8 item medication adherence scale to statins concords with pill count method and correlates with serum lipid profile parameters and Serum HMGCoA Reductase levels

2019 ◽  
Author(s):  
Abhinav Grover ◽  
Mansi Oberoi ◽  
Harmeet Rehan ◽  
Lalit Gupta ◽  
Madhur Yadav
Keyword(s):  
Medication Adherence ◽  
Lipid Profile ◽  
Density Lipoprotein ◽  
Correlation Coefficients ◽  
Pill Count ◽  
Self Report ◽  
Adherence Score ◽  
Count Method ◽  
High Adherence ◽  
Adherence Scale

ABSTRACTBackgroundIt is imperative that non-compliance to statins be identified and addressed to optimize the clinical benefit of statins. Patient self-reporting methods are convenient to apply in clinical practice but need to be validated.ObjectiveWe studied the concordance of a patient self-report method, MMAS (Morisky eight item medication adherence scale) with pill count method in measuring adherence to statins and their correlation with extended lipid profile parameters and serum HMGCoA-R (hydroxymethylglutaryl coenzyme A reductase) enzyme levels.MethodsMMAS and pill count method were used to measure the adherence to statins in patients on statins for any duration. Patients were subjected to estimation of extended lipid profile and serum HMGCoA-R levels at the end of 3 months follow-up.ResultsOut of a total of 200 patients included in the study, 117 patients had low adherence (score less than 6 on MMAS) whereas 65 and 18 patients had medium (score 6 to less than 8) and high adherence (score of 8) respectively. Majority of patients who had low adherence to statins by MMAS were nonadherent by pill count method yielding concordance of 96.5%. Medium or high adherence to statins by MMAS method had concordance of 89.1% with pill count method. The levels of total cholesterol, low density lipoprotein-cholesterol, apolipoprotein B and HMGCoA-R were significantly negatively correlated with compliance measured by pill count and MMAS with similar correlation coefficients. HMGCoA-R levels demonstrated a plateau phenomenon with levels being 9-10 ng/ml when compliance to statin therapy was greater than 60% by pill count and greater than 6 on Morisky scale.ConclusionIn conclusion, MMAS and pill count methods showed concordance in measuring adherence to statins. These methods need to be explored further for their interchangeability as surrogates for biomarker levels.

scholarly journals Self-reported adherence to pharmacotherapy in cancer patients

2020 ◽  
Vol 9 (6) ◽  
pp. 854
Author(s):  
Shakeel Ahmad Mir ◽  
Mehraj Ud-Din Bhat ◽  
Danish Shakeel
Keyword(s):  
Medication Adherence ◽  
Cancer Patients ◽  
Low Income ◽  
Economic Status ◽  
Income Group ◽  
Self Report ◽  
High Income Group ◽  
Middle Income ◽  
High Adherence ◽  
Adherence Scale

Background: Medication adherence is a challenging issue. Non-adherence has been found to be associated with increased healthcare costs. Pharmacological anticancer therapies are increasingly shifting to oral medications. Oral therapy is more convenient and easier to administer but various issues are related to oral anticancer therapy, the prominent one being adherence.Methods: Single group, non-randomized, self-report study conducted from December, 2019 to February, 2020 in SKIMS Hospital, Kashmir. A novel medication adherence scale, General Medication Adherence Scale (GMAS) was used to assess the adherence.Results: The study population consists of 58.7% males and 41.3% females. 54.7% patients were illiterate and 45.3% patients were literate. 13.3% patients received one drug, 14.7% two drugs, 40.0% three drugs, and 32.0% received more than three drugs. 13.3% patients had poor, 9.3% low, 42.7% partial, 12.0% good and 22.7% high adherence. In low income group, 6.7% patients had poor, 6.7% low, 13.3% partial, 26.7% good and 46.7% high adherence. Among middle income group, 10.0% patients had poor, 10.0% low, 53.3% partial, 10.0% good and 16.7% high adherence. In high income group, 20.0% patients had poor, 10.0% low, 46.7% partial, 6.7% good and 16.7% high adherence.Conclusions: Most of the cancer patients were partially adherent to the prescribed medication. Various associated factors were gender, socio-economic status, literacy, and place of residence. Considerable variation in adherence was found in this study.

High but not low self-reported statin adherence was confirmed by a novel method based on plasma-statin measurements in coronary outpatients

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
O Kristiansen ◽  
E Sverre ◽  
K Peersen ◽  
MW Fagerland ◽  
E Gjertsen ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Direct Method ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density Lipoprotein Cholesterol ◽  
The Past ◽  
High Adherence ◽  
Adherence Scale ◽  
Statin Adherence ◽  
Reduced Adherence

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Helse Sør-Øst Background To what extent self-reported adherence measures correspond with directly measured statin adherence is unknown. Purpose  To determine the relationship between, self-reported adherence measures, low density lipoprotein-cholesterol (LDL-C) and directly measured statin adherence in coronary outpatients. Methods Patients on atorvastatin (N = 373) participated in a cross-sectional study median 16 months after a coronary event. Adherence to statins the past 7 days, general medication adherence assessed by the 8-item Morisky medication adherence scale (MMAS-8), and the Gehi adherence question was obtained by a self-report questionnaire. Atorvastatin was determined in spot blood plasma samples by a novel liquid-chromatography tandem mass-spectrometry method discriminating between adherence (0-1 doses omitted) and reduced (≥2 doses omitted) adherence. Participants were unaware of the atorvastatin analyses at study participation.  Results Mean age was 63 (SD 9) years and 19% were females. Mean atorvastatin dose was 64 (SD 21) mg. The number with reduced adherence by the different measurement methods, Cohens kappa agreement score between the self-reported and direct adherence measures, and LDL-C are shown in the Table. Statin adherence was confirmed by the direct method among 96% reporting high statin adherence the past 7 days, among 95% reporting high adherence on the MMAS-8 and among 94% reporting high adherence on the Gehi adherence question. In contrast, among patients classified with reduced statin adherence by the direct method, only 40% reported reduced statin adherence the past week, 32% reported reduced adherence with the MMAS-8 and 22% with the Gehi adherence question. Conclusions The direct method confirmed high, but not low, self-reported statin adherence in this selected sample of coronary outpatients. In patients with elevated LDL-cholesterol, plasma-statin measurements emerges as a potential improvement for clinical statin management. Adherence measures and LDL cholesterol Directly measured atorvastatin adherence Self-reported statin adherence past 7 days Self-reported medication adherence past month (Gehi) 8-item Morisky medication adherence scale Number with reduced adherence, % 7.8 5.5 3.0 8.4 Cohen"s kappa (95% CI) Reference 0.4 (0.2 to 0.6) 0.3 (0.1 to 0.5) 0.2 (0.1 to 0.4) LDL-C, Adherent, mean (95% CI) 1.9 (1.8 to 1.9) 1.9 (1.8 to 2.0) 1.9 (1.8 to 2.0) 1.9 (1.8 to 1.9) LDL-C, Reduced adherence, mean (95% CI) 2.8 (2.4 to 3.2) 2.8 (2.3 to 3.2) 3.2 (2.5 to 3.8) 2.1 (1.9 to 2.4) LDL-C, Adherent versus reduced adherence P <0.001 P = 0.001 P = 0.004 P = 0.07 Agreement between directly measured atorvastatin adherence, self-reported measures of adherence, and mean low density lipoprotein-cholesterol (LDL-C)

scholarly journals Simultaneous Use of Two Different Tools to Assess Compliance with Antiepileptic Drugs: Experience in A Community-Based Study

2020 ◽  
Vol 11 (04) ◽  
pp. 636-639
Author(s):  
Paramjit Singh ◽  
Kanchan Gupta ◽  
Gagandeep Singh ◽  
Sandeep Kaushal
Keyword(s):  
Head Injuries ◽  
Emergency Department Visits ◽  
Pill Count ◽  
Self Report ◽  
Chi Square ◽  
Breakthrough Seizure ◽  
Adherence Scale ◽  
Pill Counts ◽  
Chi Square Test ◽  
Relationship Of

Abstract Objective Antiepileptic drug (AED) therapy remains the primary form of treatment for epilepsy, noncompliance to which can result in breakthrough seizure, emergency department visits, fractures, head injuries, and increased mortality. Various tools like self-report measures, pill-counts, medication refills, and frequency of seizures can assess compliance with varying extent. Thus, assessment of compliance with AEDs is crucial to be studied. Materials and Methods Compliance was assessed using pill-count and Morisky medication adherence scale (MMAS) during home visits. A pill-count (pills dispensed–pills remaining)/(pills to be consumed between two visits) value of 0.85 to ≤1.15 was recorded as appropriate compliance. Underdose (<0.85) and overdose (>1.15) was labeled as noncompliance. Score of 1 was given to each positive answer in MMAS. Score of ≥1 was labeled as noncompliance.Statistical analysis: Relationship of demographic factors between compliant and noncompliant patients was analyzed using Chi-square test (SPSS version 21.0, IBM). Rest of the data was analyzed with the help of descriptive statistics using Microsoft Excel. p< 0.05 was considered statistically significant. Results Out of 105 patients, 54 patients were noncompliant with both pill-count and MMAS. 10 patients were noncompliant with pill-count only, while 10 were noncompliant with MMAS. Conclusion Both tools complement each other when used in combination, as use of a single tool was not able to completely detect compliance.

scholarly journals The Medication Adherence Score: A Predictive Analytic Tool

2020 ◽  
Author(s):  
Tom Brouwer ◽  
Reinoud E. Knops ◽  
Martin C. Burke ◽  
Vivek Y. Reddy
Keyword(s):  
Atrial Fibrillation ◽  
Medication Adherence ◽  
Clinical Outcomes ◽  
Adherence Behavior ◽  
Individual Level ◽  
Analytic Tool ◽  
Adherence Score ◽  
Study Results ◽  
High Adherence ◽  
The Individual

Abstract Background Poor medication adherence is wide-spread and associated with poor clinical outcomes. Herein, we introduce the Medication Adherence Score, a predictive analytic tool designed to provide clinicians insight into adherence behavior over the subsequent twelve months. The aim of the study was to demonstrate the feasibility of such scoring of patients at the individual level. Methods This is a single arm, non-randomized, 2-center, retrospective cohort study conducted among patients diagnosed with atrial fibrillation. The model, developed by Fair Isaac Corporation on pharmacy refill data, predicts adherence behavior to cardiovascular drugs using demographic, geographic and socio-economic predictors. The primary outcome was the number of patients that could be scored at the individual level without reliance on past individual refill behavior. The score was normalized between zero (lowest adherence score) and one (highest adherence score) and patients were grouped: low adherence < 0.6, intermediate adherence between 0.6 and 0.8, high adherence > 0.8. The institutional review board approved the study. Results A total of 1110 patients were included in the study with a median age of 71 (IQR 63, 79). Most patients (807, 73%) could be scored at the patient level, and the remaining patients (303, 27%) were scored based on characteristics associated with the geography of their home address. There were 488 patients (44%) with a high adherence score (score > 0.8), 382 (34%) with an intermediate adherence score (score between 0.6 and 0.8) and 240 patients (22%) with a low score. Younger patients had on average lower scores than older patients, and males also had higher scores. Conclusions The Medication Adherence Score was successfully applied to an unselected group of atrial fibrillation patients: nearly a quarter of the cohort were identified as at risk for non-adherence. Future studies are necessary to assess the association of this predictive analytic model with clinical outcomes.

Use of a Self-Report Medication Adherence Scale for Measuring Adherence to Antiretroviral Therapy in Patients With HIV/AIDS

2018 ◽  
Vol 26 (2) ◽  
pp. E72-E88 ◽  
Author(s):  
Karen E. Wickersham ◽  
Susan M. Sereika ◽  
Hyung-Joo Kang ◽  
Lisa K. Tamres ◽  
Judith A. Erlen
Keyword(s):  
Medication Adherence ◽  
Antiretroviral Therapy ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Internal Consistency Reliability ◽  
Self Report ◽  
Regimen Complexity ◽  
Adherence Scale ◽  
Test Retest Reliability ◽  
Hiv Aids

Background and Purpose:This study examined the psychometric properties of a 9-item Morisky Medication Adherence Scale (MMAS-9) adapted specifically for patients with HIV/AIDS.Methods:We used data from two randomized controlled trials investigating telephone-delivered interventions for improving adherence to antiretroviral therapy to assess reliability (Cronbach’s α and Pearson’s product correlation) and validity (convergent and concurrent) of the MMAS-9.Results:The internal consistency (Cronbach’s α) of the MMAS-9 was .66 (study 1) and .69 (study 2); 3-month test–retest reliability (Pearson’s correlation) ranged from .50 to .74. Validity was supported by associations with electronic event monitored adherence, social support, depressive symptoms, self-efficacy, stigma, regimen complexity, and impact of side effects in the hypothesized direction.Conclusions:The adapted MMAS-9 demonstrated good convergent validity but somewhat lower internal consistency reliability than other reports.

scholarly journals Variations of a Commonly Used Medication Adherence Assessment Scale: Do Changes in Scale Change Structure Results?

2018 ◽  
Vol 34 (6) ◽  
pp. 252-258
Author(s):  
Brittney M. Nobles ◽  
Steven R. Erickson
Keyword(s):  
Medication Adherence ◽  
Health Care Professionals ◽  
Self Report ◽  
Major Barrier ◽  
Response Options ◽  
Multiple Medication ◽  
Reference Scale ◽  
Adherence Assessment ◽  
Scale Scores ◽  
Adherence Scale

Background: Medication nonadherence is a major barrier to both patients and health care professionals when trying to manage medical conditions. An appropriate self-report adherence tool would be helpful in determining a patient’s medication adherence. Objectives: To observe variations in scale scores based on modifications to an Original Adherence Scale, with the hypothesis that making modifications to the Original Adherence Scale will create variations in the percentage of adherent patients. Methods: This cross-sectional study utilized mailed surveys to people identified in a prescription claims administrative dataset who had a pharmacy claim for at least 2 antihypertensive medications. One thousand people were equally divided and randomly placed in 1 of 4 groups: Original Adherence Scale Group, Time Reference Scale Group, 4-Point Likert-Type Scale Group, Multiple Medication Scales Group. Each scale underwent assessment of internal reliability using Cronbach’s α. Changes made to the Original 4-item scale included altering the time reference period from 3 months to 7 days, changing response options from Yes/No to a Likert-type scale, and incorporating multiple scales so that the respondent may report on up to 4 different options. Results: There were 437 surveys completed appropriately, yielding a 46.4% response rate. The overall scale scores indicating perfect adherence was 51.8% for the 4-Point Likert-Type Scale Group, 66.5% for the Multiple Medication Scales Group, 68.8% for the Original Adherence Scale Group, and 78.9% for the Time Reference Scale Group. Conclusion: When there are more selection options, a change in time reference, or more medications reported, the amount of adherent patients varied.

Pill Count, Self-Report, and Pharmacy Claims Data to Measure Medication Adherence in the Elderly

1998 ◽  
Vol 32 (7-8) ◽  
pp. 749-754 ◽  
Author(s):  
Ruby E Grymonpre ◽  
Cathy D Didur ◽  
Patrick R Montgomery ◽  
Daniel S Sitar
Keyword(s):  
Medication Adherence ◽  
Repeated Measures ◽  
Claims Data ◽  
Pill Count ◽  
Self Report ◽  
Data Sources ◽  
Controlled Study ◽  
Unexpected Finding ◽  
Claims Database ◽  
Wellness Center

OBJECTIVE: To compare medication adherence calculated from four different data sources including a pill count and self-report obtained during a home medication history, as well as calculations based on refill frequency derived from a provincial prescription claims database (manual and electronic). DESIGN: Baseline medication adherence was collected as part of a prospective, randomized, controlled study. Mean medication adherence results obtained from the four data sources were compared using repeated-measures ANOVA followed by a Tukey's multiple range test. SETTING: A pharmacy consultation service located at an interdisciplinary wellness center for noninstitutionalized elderly. PATIENTS: 65 years or older, noninstitutionalized, taking one or more prescribed or nonprescribed medications. Clients would either present to the wellness center or be referred by the Provincial Home Care program. RESULTS: When calculated from self-report or manual or electronic prescription claims data, mean percent adherence by drug was high and not statistically different (95.8% ± 17.1%, 107.6% ± 40.3%, and 94.6% ± 24.0%, respectively), whereas the pill count adherence was significantly lower at 74.0% ± 41.5% (p < 0.0001). CONCLUSIONS: An unexpected finding was that the pill count technique used in this study of elderly clients using chronic, repeat medications appeared to underestimate medication adherence. Numerous other limitations of pill count, self-report, and a province-wide prescription claims database in estimating medication adherence are presented. When using medication adherence as a process measure, the researcher and practitioner should be aware of the limitations unique to the data source they choose, and interpret data cautiously.

scholarly journals The Nursing Assessment of Medication Acceptance: the reliability and validity of a schizophrenia medication adherence scale

2016 ◽  
Vol 7 (1) ◽  
pp. 11-16
Author(s):  
Hikaru Hori ◽  
Nobuhisa Ueda ◽  
Hideki Shiozuka ◽  
Ryohei Igata ◽  
Tazuko Miki ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Objective Assessment ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Japanese Patients ◽  
Test Method ◽  
Validity And Reliability ◽  
Nursing Assessment ◽  
Good Reliability ◽  
Adherence Scale

Background: Many patients with schizophrenia have low medication adherence. There is, however, no objective assessment scale that can be used by nurses or caregiver specialists. The Nursing Assessment of Medication Acceptance (NAMA) was developed to assess patients’ medication adherence. The aim of this study was to examine the validity and reliability of the NAMA in patients with schizophrenia. Methods: A total of 121 Japanese patients with schizophrenia were enrolled. All patients underwent evaluation using the NAMA and the Drug Attitude Inventory (DAI-10). Reliability was investigated using a test-retest method and a parallel-test method. To determine the test-retest reliability of the NAMA, we tested 101 schizophrenia patients twice, with the second assessment 2–4 weeks after the date of the first assessment. For validity verification, standard-related validity and the degree of concordance with the DAI-10 scores were measured. Results: The Cronbach’s alpha value of the NAMA in schizophrenia was 0.88. The test-retest correlation coefficients were all between 0.53–0.74. The total scores and all subscores for the NAMA were significantly correlated, and the NAMA total scores were significantly correlated with the DAI-10 total scores. Conclusions: The NAMA shows good reliability and validity in measuring medication adherence in schizophrenia.

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