Table 2.
Selected Adherence Self-Report Measures in Chronic Disease Reporting Validity Data
| Domain | Self-Report Measure | Item Count | Recall Period | Validity Data |
|---|---|---|---|---|
| Asthma | Four Item Questionnaire for Asthma Inhaler Adherence [113] | 4 items | Not specified | Correlation with controller compliance ratio = .348; Correlation with pharmacy claims data = .382; Cronbach alpha = .86. |
| Pediatric Inhaler Adherence Questionnaire [112] | 6 items | Not specified | Correlation = .42 with canister weight change, sensitivity 50-75 %. | |
| Hemophilia | Hemophilia Regimen Treatment Adherence Scale [114] | 24 items | Not specified | Cronbach alpha = .94, test-retest = .77 (m = 28 days), self-reported adherence correlated with self-reported infusions. |
| HIV/AIDS | AIDS Clinical Trials Group (ACTG) Adherence Questionnaire [43, 115] | 1-5 | Past 3 days; past 4 days; Past 2 days and past Saturday; Past week; Past month | Scores of studies demonstrating statistically significant correlations with HIV viral load. |
| Community Programs for Clinical Research on AIDS (CPCRA) Antiretroviral Medication Self-Report (3 or 7 day adherence version) [31] |
Global 3 or 7 day recall for use of medication; also includes a checklist with 10 possible reasons for missed antiretroviral doses | Past 3 days; Past 7 days | Predicts virologic suppression (OR, 3.41; 95 % CI, 2.29–5.06; p < .001); dose–response relationship with CD4+ cell count (p < .001); adherence was significantly associated with undetectable viral load, change in viral load, and change in CD4+ cell counts during a 12-month period. | |
| Self-Rating Scale Item (SRSI) [68, 69] | 1 item | Last 30 days | Significantly predictive of HIV viral load and immunologic outcome (CD4 count); superior to other self-report measures when predicting viral load or MEMS adherence. | |
| Self-Reported Adherence (SERAD) Questionnaire [116] | Three components (second part includes a 13-item section on reasons for nonadherence) | Past week/month/3 months | Relatively high agreement with other adherence measures (75 % with electronic monitoring and 71 % with pill count). | |
| Self-Reported Questionnaire Assessing Adherence to Antiretroviral Medication [117] | 9 main questions | Past day, Penultimate day, past week, past month | Sensitivity, 71 %; specificity, 72 %; correct classification, 72 %; odds ratio, 6.15. | |
| Simplified Medication Adherence Questionnaire (SMAQ) [37] |
6 items | Past day; Past week; past weekend; days over past 3 months | Cronbach's α = .75, and good inter-observer agreement (88.2 %); SMAQ showed 72 % sensitivity, 91 % specificity and a likelihood ratio of 7.94 in identifying non-adherent patients as compared to the MEMS. | |
| Visual Analog Scale (VAS) [94, 95, 118] | 1 item (patients mark a linear scale to indicate percent adherence) | 1 month | Significant associations with unannounced pill counts and HIV viral load (r = 0.76 and −0.49); significantly correlated with the ACTG adherence questionnaire (r = 0.59, p < 0.0001). | |
| Hypertension | Brief Adherence Self-Report Questionnaire (ASRQ) [119, 120] | 6 items | Not specified | Sensitivity 46 % & specificity 66 % with MEMS cap timing adherence. |
| Hill-Bone Compliance to high blood pressure therapy scale [62] | 14 items (three subscales for reduced sodium, appointment keeping, and medication taking) | Not specified | Cronbach’s α = 0.74 and 0.84 in two samples, and mean inter-item correlations were 0.18 and 0.28. | |
| Voils Measure of Extent and Reasons for Medication Non-Adherence [52] | 3 items on extent of non-adherence and 21 items on reasons for non-adherence | Last 7 days | Extent items significantly predicted systolic and diastolic blood pressure and showed Cronbach’s α = .81 over 21 days. | |
| Immuno-suppression | Frazier Noncompliance Inventory (FNI) [121, 122] | 11 items | Not specified | Association between measure and self-rating of adherence & pill counts. |
| Immunosuppressive Adherence Scale (ITAS) [123] | 5 items | Not specified | Cronbach’s α = .81, positive correlations with refill record and serum immunosuppression levels. | |
| Medication Therapy Adherence Scale (ITAS-M) [124] | 4 items | 3 months | Modified ITAS; designed to address all medications. | |
| Mental health | Brief Adherence Rating Scale (BARS) [125] | 4 items | Number of days over past month | Cronbach's α = .92 and test–retest reliabilities ranged from r = 0.46 to 0.86; Spearman correlations between MEMS and the BARS for each month of 6-month trial were moderate (0.42–0.59); BARS showed good sensitivity (73 %) and specificity (71 %) in identifying non-adherent outpatients. |
| Tablets Routine Questionnaire (TRQ) [126] | 2 general questions regarding any difficulties taking or coping with medications followed by 4 questions regarding approximate number of missed doses in the past week and past month | Past Week/Month | Adherence scores significantly related (r = .24, p < .04) to lithium levels; partial adherence score (missing 30 % or more of prescribed mood stabilizers) over past week has relatively good specificity (100 % and 87 %) for nonadherence in the past 2 years and past week, respectively; partial adherence score (missing 30 % or more of medications) over past week has somewhat lower sensitivity (65 % and 84 %) for nonadherence in the past 2 year and past week, respectively. | |
| Multiple Sclerosis | Multiple Sclerosis Treatment Adherence Questionnaire (MS_TAQ) [127] | 30 items (in three subscales: Barriers, Side Effects, and Coping Strategies) | 28 days | Correlated with adherence self-report. |
| Osteoporosis | Adherence Evaluation of Osteoporosis Treatment (ADEOS-12) [128] | 12 items | Not specified | Scores between 16 and 20 predict treatment discontinuation. |
| Rheumatology | Compliance-Questionnaire-Rheumatology (CQR) [129] | 19 items | Not specified | Sensitivity = 98 %, specificity = 67 %; Kappa = .78; sensitivity = 62 % and specificity = 95 % with MEMS. |
| General Use | Adherence Estimator [130] | 3 items | Not specified | Sensitivity 88 %, specificity 59 % with self-reported adherence. |
| Adherence to Refills and Medication Scale (ARMS) [131] | 12 items | Not specified | Cronbach’s α = .81; correlation with Morisky = .65 and .3 with refill measure; low scores associated with controlled diastolic blood pressure. | |
| Brief Medication Questionnaire (BMQ) [66] | 9 items | Past week | Sensitivity = 80 % & specificity 100 % repeat non- adherence vs no nonadherence with MEMS; r = .67 dose omissions past week & r = .89 past month. | |
| Medical Outcomes Study (MOS) [132] | 5 items | Past 4 weeks | In a variety of chronic conditions, 2-year test-retest reliability = .32-.66; internal consistency = .81. | |
| Medication Adherence Scale (MAS) [133] | 32 items (subscales on knowledge, attitudes and barriers) | Not specified | Cronbach’s α = .85 (3 factors - .75 knowledge, .attitude .75, barriers .94), MEMS correlation with factors knowledge NS; attitudes .3, barriers .31. | |
| Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) [134] | 20 items | Not specified | Test-retest reliability .93 (interval not specified); cronbach’s alpha = .71; interrater reliability = .73; sensitivity .68; specificity .83. | |
| Medical Adherence Measure [135] | Semi-structured interview | 1 week | Correlated with MEMS r = .40, associated with kidney transplant rejection r = .62. | |
| Morisky Adherence Questionnaire 4 item (MAQ) [64] | 4 items | Not specified | Point biserial correlation = .43 score and .58 at 6 & 42 months; coefficient of determination = R2 = .33; sensitivity = .81; specificity = .44. | |
| Morisky Adherence Questionnaire 8 item (MAQ) [42] | 8 items | Not specified | Cronbach’s α = .83; significant association with blood pressure control (p < .05); estimated sensitivity 93 % and specificity 53 %. |