Yıldız Mustafa, Geniş Bahadır, Gürcan Mehmet Buğrahan, İncedere Aysel, Dabakoğlu Sesil, Yükseker Sevcan
Department of Psychiatry, Kocaeli University School of Medicine, Kocaeli, Türkiye.
Clinic of Psychiatry, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye.
Psychiatry Clin Psychopharmacol. 2024 Nov 28;34(4):320-327. doi: 10.5152/pcp.2024.24869.
Assessment of medication adherence of patients with severe mental disorders is an important aspect of long-term treatment. There is a need for a brief and practical tool to assess medication adherence. This study investigates the clinical, functional, and validational correlations of a short and easy-to-use tool.
Global Assessment of Medication Adherence (GAMA) was prepared as a single item with 5 severity degrees, from complete adherence (1 point) to complete nonadherence (5 points). The scale was applied to patients with severe mental illnesses receiving outpatient and inpatient treatment. The GAMA scores were compared with psychopathology, clinical severity, insight, and functionality scale scores. While the validity analyses were tested with face, convergent, and criterion validity, interrater reliability was used for the reliability analysis.
Data from 70 outpatients and 14 inpatients were examined. In the analyses performed for convergent validity, a positive correlation was found between GAMA scores and psychopathology (r=0.646, P < .001), and clinical severity (r = 0.692, P < .001), and a significant negative correlation was found between GAMA scores and insight (r = −0.793, P < .001), and functionality (r = −0.740, P < .001). There was a significant difference in the GAMA scores of 14 patients assessed during hospitalization and discharge. A high positive correlation was found between the GAMA measurements of the psychiatrist and the nurse at admission and discharge.
This study shows that the GAMA has sufficient psychometric properties for assessing medication adherence. Due to its brevity, simplicity, and validity, the scale is appropriate for use in routine clinical practice and research.
评估重症精神障碍患者的药物依从性是长期治疗的一个重要方面。需要一种简短实用的工具来评估药物依从性。本研究调查了一种简短易用工具的临床、功能及验证相关性。
全球药物依从性评估(GAMA)编制为一个单项,有5个严重程度等级,从完全依从(1分)到完全不依从(5分)。该量表应用于接受门诊和住院治疗的重症精神疾病患者。将GAMA评分与精神病理学、临床严重程度、洞察力和功能量表评分进行比较。在进行效度分析时,采用了表面效度、收敛效度和效标效度检验,信度分析采用了评分者间信度。
对70名门诊患者和14名住院患者的数据进行了检查。在收敛效度分析中,发现GAMA评分与精神病理学(r = 0.646,P <.001)和临床严重程度(r = 0.692,P <.001)之间存在正相关,而GAMA评分与洞察力(r = -0.793,P <.001)和功能(r = -0.740,P <.001)之间存在显著负相关。14名患者在住院期间和出院时评估的GAMA评分存在显著差异。在入院和出院时,精神科医生和护士的GAMA测量值之间存在高度正相关。
本研究表明,GAMA在评估药物依从性方面具有足够的心理测量学特性。由于其简短、简单和有效性,该量表适用于常规临床实践和研究。