HSR&D » For_researchers » Measurement » Instrument » Overviews

  

Enter your search text Search HSR&D: Button to start search

Instrument Summary for Compliance/Adherence

Please note that this section is an archive and is no longer being updated.

Development: The Morisky Scale includes items originally constructed to measure adherence with antihypertensive treatment. The item pool consisted of five items from a scale by Green et al. developed to assess medication-taking in outpatients treated for high blood pressure.

Purpose: To provide a brief screening measurement of adherence with treatment.

Useful Facts: The Morisky Scale has four items with dichotomous (yes/no) response options. The sum of 'yes' responses provides a total score of nonadherence. The Scale has been used extensively among patients with varying medical conditions. It has been noted that some researchers question the item "Do you ever forget to take your medicine?" because it might not distinguish between those who regularly forget their doses and those who have forgotten a few times only.

VA Relevance: No information has been found regarding the use of this instrument with veteran populations.

Availability:

References:

1. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence.Med Care. 1986 Jan;24(1):67-74. [Abstract ]
2. Gao X, Nau DP. Congruence of three self-report measures of medication adherence among HIV patients. Ann Pharmacother 2000;34:1117-22. [Abstract ]
3. Shalansky SJ, Levy AR, Ignaszewski AP. Self-reported Morisky score for identifying nonadherence with cardiovascular medications. Ann Pharmacother. 2004 Sep;38(9):1363-8. Epub 2004 Jul 6. [Abstract ]

Development: The AACTG Adherence Instruments include two self-report instruments originally designed for use in the AACTG to assess adherence for treatment and its correlates. They were initially administered to 75 HIV/AIDS patients taking combination antiretroviral therapy at ten different sites across the U.S.

Purpose: To assess compliance with combination antiretroviral therapy (ART).

Useful Facts: Administration time is approximately 10 minutes for each instrument. The instruments focus on recent adherence (as early as 'yesterday'). One instrument specifically assesses adherence to antiretroviral medications, while the other assesses the baseline correlates of adherence. The baseline correlates questionnaire is completed only upon entry into the trial or study. The questionnaires have been translated into French, Italian, and Spanish. The current baseline and adherence questionnaires include an additional section developed by Drs. Linda Rabaneck and Amy Justice. The instruments are available at the Center for AIDS Prevention Studies.

VA Relevance: No information has been found regarding the use of these instrument with veteran populations.

Availability: The instruments are available at the Center for AIDS Prevention Studies website http://www.caps.ucsf.edu/tools/surveys/

References:

1. Center for AIDS Prevention Studies Instruments. Center for AIDS Prevention Studies. Accessed July 2005. Available URL: http://www.caps.ucsf.edu/projects/instrumentindex.html#8.
2. Chesney MA, Ickovics JR, Chambers DB, Gifford AL, Neidig J, Zwickl B, Wu AW. Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group (AACTG). AIDS Care. 2000 Jun;12(3):255-66. [Abstract ]
3. Reynolds NR, Testa MA, Marc LG, Chesney MA, Neidig JL, Smith SR, Vella S, Robbins GK; Protocol Teams of ACTG 384, ACTG 731 and A5031s. Factors influencing medication adherence beliefs and self-efficacy in persons naive to antiretroviral therapy: a multicenter, cross-sectional study.AIDS Behav. 2004 Jun;8(2):141-50. [Abstract ]

Development: The General Adherence Scale items were first published as part of the Medical Outcomes Study (MOS) to assess the treatment adherence of patients with diabetes, hypertension, and heart disease. Data were collected on patients from three systems of care (health maintenance organizations/HMOs, large multispecialty groups/LMSGs, and private practices in Boston, Chicago, and Los Angeles. The items assess a patient's self-reported success with adhering to recommendations as well as the ease of following such recommendations.

Purpose: To assess patients' general tendency to adhere to a prescribed medical treatment. It provides an overall look at patient difficulty and success with following recommendations.

Useful Facts: The GAS takes less than 5 minutes to administer. There are five items that are scored on a 6-point Likert scale from 'none of the time' (1) to 'all of the time' (6). Responses are averaged after reversing the scoring of items 1 and 3, and transformed to a linear 0 - 100 distribution. (Ref: 1) A higher score means a higher degree of adherence to medical recommendations.

VA Relevance: No information has been found regarding the use of these instrument with veteran populations.

Availability: The instrument is available from the RAND website. http://www.rand.org/health/surveys_tools/mos/mos_adherence.html

References:

1. DiMatteo MR, Hays RD, Sherbourne CD. Adherence to cancer regimens: implications for treating the older patient. Oncology.1992 Feb;6(2 Suppl):50-7. [Abstract ]
2. DiMatteo MR, Sherbourne CD, Hays RD, Ordway L, Kravitz RL, McGlynn EA, Kaplan S, Rogers WH. Physicians' characteristics influence patients' adherence to medical treatment: results from the Medical Outcomes Study. [Abstract ]
3. Hays RD. The medical outcomes study (MOS) measures of patient adherence. [serial online]. Accessed July 2005. Available URL: http://www.rand.org/health/surveys_tools/mos/mos_adherence.html.