Jose Maria, Rajmohan Priyanka, Sulfath T S, Varma Ravi Prasad, Mohan Manoj, Jose Nisha K, Cherian Jerin Jose, Bairwa Mohan Lal, Goswamy Tulika, Apte Aditi, Kuttichira Praveenlal, Thomas Joe
Department of Pharmacology, Jubilee Mission Medical College & Research Institute, Thrissur, India.
Department of Community Medicine, Jubilee Mission Medical College & Research Institute, Thrissur, India.
PLoS One. 2025 May 14;20(5):e0321423. doi: 10.1371/journal.pone.0321423. eCollection 2025.
NCDs arise from complex interactions of modifiable factors such as unhealthy lifestyles, poor diet, and psychosocial challenges, along with non-modifiable factors like age and genetics. Notably, medication non-adherence is a widespread and growing concern, significantly contributing to disease progression and poor outcomes globally.
This scoping review aims to synthesize evidence on medication adherence scales used for selected non communicable diseases. It examines their development methods, psychometric properties, and assessed domains, while identifying gaps or limitations in their design and application.
The Joanna Briggs Institute methodological framework guided this scoping review and the protocol was registered prospectively to ensure methodological transparency and rigor. Electronic databases, the reference list of included articles, and grey literature were searched. Studies published in English from January 1950 to June 2024 were included. Two reviewers independently screened all articles, and a third reviewer settled any conflicts between the reviewers. Critical appraisal of the screened-in articles was done using JBI critical appraisal scales. The data was compiled into tables and a narrative summary that is consistent with the review's goal.
Our study included 140 articles, identifying 57 medication adherence scales. These scales, developed using qualitative methods (10.8%), literature review (32.4%), and mixed methods (45.9%), primarily focus on behavior, often neglecting cost-related non-adherence, self-efficacy, and systemic barriers. Psychometric findings varied widely, reflecting heterogeneity in study designs and scale development approaches. Many scales lack validation in diverse settings, underscoring the need for comprehensive, context-sensitive tools.
This scoping review highlights gaps in existing medication adherence scales for NCDs, particularly their limited consideration of socioeconomic and cultural factors and incomplete adherence assessment. Future research should focus on developing more holistic, contextually relevant adherence scales that integrate these dimensions. Strengthening adherence measurement methodologies can enhance patient-centered care, inform policy interventions, and improve health outcomes.
非传染性疾病（NCDs）源于多种因素的复杂相互作用，其中包括可改变的因素，如不健康的生活方式、不良饮食和心理社会挑战，以及不可改变的因素，如年龄和遗传。值得注意的是，药物治疗依从性不佳是一个普遍且日益严重的问题，在全球范围内对疾病进展和不良后果有重大影响。
本范围综述旨在综合有关用于特定非传染性疾病的药物治疗依从性量表的证据。它研究这些量表的开发方法、心理测量特性和评估领域，同时识别其设计和应用中的差距或局限性。
乔安娜·布里格斯研究所的方法框架指导了本范围综述，研究方案已预先注册，以确保方法的透明度和严谨性。检索了电子数据库、纳入文章的参考文献列表和灰色文献。纳入了1950年1月至2024年6月以英文发表的研究。两名评审员独立筛选所有文章，第三名评审员解决评审员之间的任何冲突。使用JBI批判性评价量表对筛选出的文章进行批判性评价。数据被整理成表格和与综述目标一致的叙述性总结。
我们的研究纳入了140篇文章，确定了57种药物治疗依从性量表。这些量表采用定性方法（10.8%）、文献综述（32.4%）和混合方法（45.9%）开发，主要关注行为，常常忽视与成本相关的不依从、自我效能和系统性障碍。心理测量结果差异很大，反映出研究设计和量表开发方法的异质性。许多量表在不同环境中缺乏验证，这凸显了对全面的、因地制宜的工具的需求。
本范围综述突出了现有非传染性疾病药物治疗依从性量表的差距，特别是它们对社会经济和文化因素的考虑有限以及依从性评估不完整。未来的研究应侧重于开发更全面、与背景相关的依从性量表，将这些维度整合进去。加强依从性测量方法可以提高以患者为中心的护理水平，为政策干预提供信息，并改善健康结果。
