Abstract
BackgroundWe examined the psychometric properties of the Korean version of the 8-item Morisky Medication Adherence Scale (MMAS-8) among adults with hypertension.MethodsA total of 373 adults with hypertension were given face-to-face interviews in 2 cardiology clinics at 2 large teaching hospitals in Seoul, South Korea. Blood pressure was measured twice, and medical records were reviewed. About one-third of the participants (n = 109) were randomly selected for a 2-week test-retest evaluation of reliability via telephone interview.ResultsInternal consistency reliability was moderate (Cronbach α = 0.56), and test-retest reliability was excellent (intraclass correlation = 0.91; P < 0.001), although a ceiling effect was detected. The correlation of MMAS-8 scores with scores for the original 4-item scale indicated that convergent validity was good (r = 0.92; P < 0.01). A low MMAS-8 score was significantly associated with poor blood pressure control (χ2 = 29.86; P < 0.001; adjusted odds ratio = 5.08; 95% CI, 2.56–10.08). Using a cut-off point of 6, sensitivity and specificity were 64.3% and 72.9%, respectively. Exploratory factor analysis identified 3 dimensions of the scale, with poor fit for the 1-dimensional construct using confirmatory factory analysis.ConclusionsThe MMAS-8 had satisfactory reliability and validity and thus might be suitable for assessment and counseling regarding medication adherence among adults with hypertension in a busy clinical setting in Korea.
Highlights
Inadequate adherence to antihypertensive drug therapy is a very common factor in uncontrolled blood pressure (BP).[1,2] The World Health Organization (2003) estimated that adherence rates range from 50% to 70%, the relevant studies varied with respect to study population, duration of follow up, and method used to assess adherence.[3]
Physicians should carefully assess noncompliance with antihypertensive drugs and inform patients about hypertension management, they are unable to do so due to the limited time for physician consultation and lack of attention to BP control.[6]
There were no significant differences among the 3 adherence groups with respect to sex, education level, number of comorbidities, or body mass index (BMI)
Summary
Inadequate adherence to antihypertensive drug therapy is a very common factor in uncontrolled blood pressure (BP).[1,2] The World Health Organization (2003) estimated that adherence rates range from 50% to 70%, the relevant studies varied with respect to study population, duration of follow up, and method used to assess adherence.[3]. Many individuals with hypertension have negative feelings toward antihypertensive drugs and lack knowledge of hypertension They sometimes do not appreciate the need to continue medication even when they no longer have symptoms.[5] Second, physicians should carefully assess noncompliance with antihypertensive drugs and inform patients about hypertension management, they are unable to do so due to the limited time for physician consultation and lack of attention to BP control.[6] These limitations might be due to characteristics of the Korean health care system, such as the fact that reimbursement for outpatients is based on a fee-for-service model rather than on capitation payment. Conclusions: The MMAS-8 had satisfactory reliability and validity and might be suitable for assessment and counseling regarding medication adherence among adults with hypertension in a busy clinical setting in Korea
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