Self-reported questionnaires for assessing medication adherence in coronary heart disease patients: A systematic review 10.55131/jphd/2026/240225
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Abstract
Medication adherence is essential for assessing the effectiveness of treatment in people with coronary heart disease (CHD). It is evaluated through self-report, which is the most economical and straightforward method. This systematic review aimed to identify validated self-report questionnaires that measure medication adherence in patients with CHD.The study adhered to the PRISMA guidelines for carrying out systematic reviews. A total of 23 articles were selected according to the inclusion criteria, from three databases, namely PubMed, ScienceDirect, and Scopus. The Joanna Briggs Institute (JBI) Critical Appraisal Instrument was used to independently evaluate the quality of the included articles.
The most generally used self-report questionnaires for assessing medication adherence in patients with CHD were the MMAS-4 and MMAS-8, each applied in 22% of the studies. These were followed by the MARS-5, MGLS, and ACDS, each used in 13% of the studies. The results showed that most questionnaires had acceptable reliability (Cronbach’s α = 0.739–0.898) and validity (content and construct). However, few articles evaluated questionnaires across diverse cultural contexts or assessed their sensitivity to partial or intermittent medication adherence.
The MMAS-4 and MMAS-8 were the most commonly used validated self-report adherence questionnaires. Despite presenting acceptable psychometric properties, questionnaires had limited cultural adaptation and sensitivity to partial or intermittent adherence. This emphasized the need for further validation and the development of tools better tailored to diverse clinical settings and study contexts.
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