Chung Wen Wei, Chua Siew Siang, Lai Pauline Siew Mei, Morisky Donald E
Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Pharmacy Department, University Malaya Medical Centre, Kuala Lumpur, Malaysia.
Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
PLoS One. 2015 Apr 24;10(4):e0124275. doi: 10.1371/journal.pone.0124275. eCollection 2015.
Medication non-adherence is a prevalent problem worldwide but up to today, no gold standard is available to assess such behavior. This study was to evaluate the psychometric properties, particularly the concurrent validity of the English version of the Malaysian Medication Adherence Scale (MALMAS) among people with type 2 diabetes in Malaysia. Individuals with type 2 diabetes, aged 21 years and above, using at least one anti-diabetes agent and could communicate in English were recruited. The MALMAS was compared with the 8-item Morisky Medication Adherence Scale (MMAS-8) to assess its convergent validity while concurrent validity was evaluated based on the levels of glycated hemoglobin (HbA1C). Participants answered the MALMAS twice: at baseline and 4 weeks later. The study involved 136 participants. The MALMAS achieved acceptable internal consistency (Cronbach's alpha=0.565) and stable reliability as the test-retest scores showed fair correlation (Spearman's rho=0.412). The MALMAS has good correlation with the MMAS-8 (Spearman's rho=0.715). Participants who were adherent to their anti-diabetes medications had significantly lower median HbA1C values than those who were non-adherence (7.90 versus 8.55%, p=0.032). The odds of participants who were adherent to their medications achieving good glycemic control was 3.36 times (95% confidence interval: 1.09-10.37) of those who were non-adherence. This confirms the concurrent validity of the MALMAS. The sensitivity of the MALMAS was 88.9% while its specificity was 29.6%. The findings of this study further substantiates the reliability and validity of the MALMAS, in particular its concurrent validity and sensitivity for assessing medication adherence of people with type 2 diabetes in Malaysia.
药物治疗依从性是一个全球普遍存在的问题，但直到如今，尚无评估此类行为的金标准。本研究旨在评估马来西亚药物治疗依从性量表（MALMAS）英文版本在马来西亚2型糖尿病患者中的心理测量特性，尤其是同时效度。招募年龄在21岁及以上、使用至少一种抗糖尿病药物且能用英语交流的2型糖尿病患者。将MALMAS与8项Morisky药物治疗依从性量表（MMAS - 8）进行比较以评估其收敛效度，同时基于糖化血红蛋白（HbA1C）水平评估同时效度。参与者在基线时和4周后两次回答MALMAS。该研究涉及136名参与者。MALMAS达到了可接受的内部一致性（Cronbach's alpha = 0.565），且重测分数显示出适度相关性（Spearman's rho = 0.412），具有稳定的可靠性。MALMAS与MMAS - 8具有良好的相关性（Spearman's rho = 0.715）。坚持服用抗糖尿病药物的参与者的HbA1C中位数显著低于不依从者（7.90%对8.55%，p = 0.032）。坚持服药的参与者实现良好血糖控制的几率是不依从者的3.36倍（95%置信区间：1.09 - 10.37）。这证实了MALMAS的同时效度。MALMAS的敏感性为88.9%，特异性为29.6%。本研究结果进一步证实了MALMAS的可靠性和有效性，特别是其在评估马来西亚2型糖尿病患者药物治疗依从性方面的同时效度和敏感性。
