Abstract
Background: Medication non-adherence is a complex multifactorial phenomenon impacting patients with various health conditions worldwide. Therefore, its detection can improve patient outcomes and minimize the risk of adverse consequences. Even though multiple self-reported medication adherence assessment scales are available, very few of them exist in Arabic language. Therefore, the aim of this study was to validate a newly translated Arabic version of the Adherence to Refills and Medications Scale (ARMS) among patients with chronic health conditions. Methods: This is a single-center cross-sectional study that was conducted between October 10th 2018 and March 23rd 2021. ARMS was first translated to Arabic using the forward-backward translation method. The translated scale was then piloted among 21 patients with chronic health conditions (e.g., diabetes, hypertension, etc.…) to examine its reliability and comprehensibility using the test-retest method. Thereafter, the Arabic-translated ARMS was self-administered to adult patients aged ≥18 years with chronic health conditions visiting the primary care clinics of a university-affiliated tertiary care hospital in Riyadh, Saudi Arabia. Construct validity was examined using factor analysis with varimax rotation. Results: Of the 264 patients who were invited to participate, 202 (76.5%) consented and completed the questionnaire. Most of the participants were males (69.9%), married (75.2%), having a college degree or higher (50.9%), retired or unemployed (65.2%), aged ≥ 50 years (65.2%), and are diabetic (95.9%). The 12-item Arabic-translated ARMS mean score was 17.93 ± 4.90, and the scale yielded good internal consistency (Cronbach’s alpha = 0.802) and test-retest reliability (Intraclass correlation coefficient = 0.97). Two factors were extracted explaining 100% of the of the total variance (factor 1 = 52.94% and factor 2 = 47.06%). Conclusions: The 12-item Arabic version of ARMS demonstrated good validity and reliability. Therefore, it should help in the detection of medication non-adherence among Arabic-speaking patient population and minimize the risk of adverse consequences.
Highlights
Medication non-adherence is a globally recognized multifactorial phenomenon impacting patients with various health conditions [1]
(65.2%), and 40.1% had a monthly income between 5000–10,000 SAR
Translating and validating the ARMS into Arabic, which is a language spoken by more than 400 million people [44], should facilitate the assessment of medication adherence among Arabic-speaking patient population, among those with chronic health conditions, such as diabetes and hypertension, which are prevalent in the Arab world [45,46,47]
Summary
Medication non-adherence is a globally recognized multifactorial phenomenon impacting patients with various health conditions [1]. In Saudi Arabia, it was reported that up to 65% of patients with diabetes visiting primary care clinics in Al Hasa province are not adherent to their prescription medications [10]. Another questionnaire-based, cross-sectional, singlecenter study has estimated that 41.7% and 33% of patients with cardiovascular disease had medium and low levels of adherence to their prescription medications, respectively [9]. The aim of this study was to validate a newly translated Arabic version of the Adherence to Refills and Medications Scale (ARMS) among patients with chronic health conditions. The translated scale was piloted among 21 patients with chronic health conditions (e.g., diabetes, hypertension, etc. . . . ) to examine its reliability and comprehensibility using the test-retest method
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