Naqvi Atta Abbas, Hassali Mohamed Azmi, Rizvi Mehwish, Zehra Ale, Iffat Wajiha, Haseeb Abdul, Jamshed Shazia
Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Penang, Malaysia.
DOW College of Pharmacy, DOW University of Health Sciences, Karachi, Pakistan.
Front Pharmacol. 2018 Oct 9;9:1124. doi: 10.3389/fphar.2018.01124. eCollection 2018.
This study aimed to develop and validate a self-reporting adherence tool termed as General Medication Adherence Scale (GMAS) in Urdu language for measuring adherence toward medication use among Pakistani patients with a chronic disease. A month-long study (December 2017) was conducted in three tertiary health care settings of Karachi, Pakistan. The tool underwent content and face validity as well as factor analyses, i.e., exploratory, partial confirmatory and confirmatory factor analyses. Random sampling was conducted, and sample size was calculated using item response theory. The item-to-respondent ratio was 1:15. Fit indices namely normed fit index (NFI), Tucker Lewis index (TLI), comparative fit index (CFI), goodness of fit index (GFI), absolute goodness of fit (AGFI), parsimony goodness of fit index (PGFI), root mean square error of approximation (RMSEA), and standard root mean square residual (SRMR) were calculated. Additionally, estimation of the convergent, discriminant and known group validities, was conducted. Internal consistency was analyzed by test-retest reliability, McDonald's and Pearson correlation coefficient. The factor analyses were conducted using IBM SPSS version 22 and IBM SPSS AMOS version 25. Content validity index (CVI) was reported at 0.8 (SD 0.147) and the tool was content validated with three hypothetical constructs. Factor analyses highlighted a 3-factor structure. The fit indices were calculated with satisfactory results, i.e., PGFI, GFI, AGFI, NFI, TLI, and CFI were greater than 0.9 and PGFI > 0.5. The values of RMSEA and SRMR were less than 0.07. A Cronbach's alpha value of 0.84 was obtained in reliability analysis. The test-retest Pearson's correlation coefficient value was reported at 0.996 (-value < 0.01). Convergent and discriminant validities for all constructs and, known group validity for two constructs, were established. A high response rate of 91% was achieved in respondents. Patients without insurance coverage appeared to be low adherent compared to those with insurance coverage (-value < 0.05). Non-comorbid patients were more likely to be highly adherent as compared to comorbid patients (-value < 0.01). A novel tool GMAS was developed in Urdu language and was subsequently validated in patients with chronic diseases.
本研究旨在开发并验证一种自我报告依从性工具，即通用药物依从性量表（GMAS），该量表为乌尔都语版本，用于测量巴基斯坦慢性病患者的用药依从性。2017年12月，在巴基斯坦卡拉奇的三个三级医疗保健机构进行了为期一个月的研究。该工具进行了内容效度和表面效度分析以及因子分析，即探索性、部分验证性和验证性因子分析。采用随机抽样，并使用项目反应理论计算样本量。项目与受访者的比例为1:15。计算了拟合指数，即规范拟合指数（NFI）、塔克·刘易斯指数（TLI）、比较拟合指数（CFI）、拟合优度指数（GFI）、绝对拟合优度（AGFI）、简约拟合优度指数（PGFI）、近似均方根误差（RMSEA）和标准均方根残差（SRMR）。此外，还进行了收敛效度、区分效度和已知组效度的估计。通过重测信度、麦克唐纳和皮尔逊相关系数分析内部一致性。因子分析使用IBM SPSS 22版和IBM SPSS AMOS 25版进行。内容效度指数（CVI）报告为0.8（标准差0.147），该工具通过三个假设结构进行了内容验证。因子分析突出了一个三因子结构。计算出的拟合指数结果令人满意，即PGFI、GFI、AGFI、NFI、TLI和CFI大于0.9且PGFI>0.5。RMSEA和SRMR的值小于0.07。在信度分析中获得的克朗巴哈α值为0.84。重测皮尔逊相关系数值报告为0.996（p值<0.01）。建立了所有结构的收敛效度和区分效度，以及两个结构的已知组效度。受访者的回应率高达91%。与有保险的患者相比，没有保险的患者依从性似乎较低（p值<0.05）。与患有合并症的患者相比，无合并症的患者更有可能具有高依从性（p值<0.01）。开发了一种乌尔都语版本的新型工具GMAS，并随后在慢性病患者中进行了验证。
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