Development of the Medication Adherence Measure for Oral Medicines : Testing in Patients with Hypertension
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Abstract
Objective: To test the reliability and validity of the Medication Adherence Measure for Oral Medicines (MAM-O) in patients with hypertension, and to identify a cut-off point for the adequate level of medication adherence. Methods: The MAM-O was revised from the MAST (Medication Adherence Scale for Thais) with 8 items and 6 response options. The study reduced the number of options to 4. The scale was examined for its content validity by 4 experts and was pilot-tested in 15 patients with hypertension. Afterwards, the MAM-O was tested in 240 patients with hypertension. All participants completed the MAM-O and the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) scale. In addition, pill counts were conducted at month 0, 3, and 6 to assess the number of remaining pills. Cut-off point of the scale was determined using the receiver operating characteristic curve (ROC curve). Results: Cronbach's Alpha coefficients of the MAM-O in months 0 and 6 were 0.73 and 0.75, respectively, which was satisfactory. Test-retest reliability was at a good level (r = 0.754). Criterion-related validity of the MAM-O was supported by its correlation to medication adherence assessed by pill counting in various times (r = 0.544-0.764; P < 0.001). Its construct validity was confirmed by its relationship with quality of life (r = 0.531; P < 0.001). The MAM-O could discriminate those with controlled blood pressure and those with uncontrolled blood pressure (P<0.001). The cut-off point of the MAM-O was 21 (from the full score of 24) with an area under the ROC curve of 0.90. Its sensitivity and specificity were 92.5 and 80.9, respectively. Conclusion: The MAM-O shows good reliability, validity, sensitivity, and specificity. Therefore, it can be used to assess medication adherence in patients with hypertension.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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