Abstract
ObjectiveThe aim was to validate the Urdu version of General Medication Adherence Scale (GMAS) in patients with rheumatoid arthritis disease.MethodsA 2-month (March–April 2019) cross-sectional study was conducted in randomly selected out-patients with rheumatoid arthritis. The sample size was calculated using item-subject ratio of 1:20. The scale was evaluated for factorial, concrete, concurrent, and known group validities. Concrete validity was established by correlating scores of EQ-5D quality of life scale and GMAS adherence score. Concurrent validity was established by correlating the GMAS adherence score with pill count. Analyses for sensitivity were also conducted. Cut-off value was determined through receiver operator curve (ROC), and test–retest method was used to analyze internal consistency and reliability. Data were analyzed through IBM SPSS, IBM AMOS, and MedCalc software. The Urdu version of EQ-5D quality of life questionnaire was used with permission from developers (#ID20884). The study was approved by an ethics committee (#NOV:15).ResultsA total of 351 responses were analyzed. The response rate was 98%. Reliability was in acceptable range, i.e., Cronbach α = 0.797. Factorial validity was established by calculation of satisfactory fit indices. Correlation coefficients for concrete and concurrent validities were ρ = 0.687, p < 0.01 and ρ = 0.779, p < 0.01, respectively. Known group validity was established as significant association of adherence score with insurance and illness duration (p < 0.05) that were reported. Sensitivity of the scale was 94%. Most patients had high adherence (N = 159, 45.3%).ConclusionThe Urdu version of GMAS demonstrated adequate internal consistency and was validated. These results indicate that it is an appropriate tool to measure medication adherence in Pakistani patients with rheumatoid arthritis.
Highlights
Rheumatoid arthritis (RA) is a chronic musculoskeletal disease that affects the synovial joints of the body and results in inflammation, stiffness, and arthralgia
Factor Analyses The factor analyses consisted of exploratory factor analysis (EFA), partial confirmatory factor analysis (PCFA), and confirmatory factor analysis (CFA) using structure equation model
Concrete Validity The concrete validity of General Medication Adherence Scale (GMAS) was established by correlating the health related quality of life (HRQoL) score obtained from Euroqol EQ VAS, with adherence score obtained from GMAS (Cronbach and Meehl, 1955; Strauss and Smith, 2009)
Summary
Rheumatoid arthritis (RA) is a chronic musculoskeletal disease that affects the synovial joints of the body and results in inflammation, stiffness, and arthralgia. It progressively deteriorates the joints and causes joint deformity that reduces mobility. The disease prevalence ranges from 0.5 to 1% with slight variation region-wise. Females are more likely to suffer from the disease as compared to the males. Evidence indicates that polar countries may have a slightly higher prevalence of RA as compared to countries in temperate, torrid, and equatorial regions (Naqvi et al, 2017; Naqvi et al, 2019a; Naqvi et al, 2019d)
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