Development and validation of a novel general medication adherence scale (GMAS) for chronic illness patients in Pakistan
Objective: 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. Methods: A month-long study (December 2017) was c...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English English English |
| Published: |
Frontiers
2018
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/66987/ http://irep.iium.edu.my/66987/ http://irep.iium.edu.my/66987/ http://irep.iium.edu.my/66987/1/Development_and_Validation_of_a_Novel_General_Medi.pdf http://irep.iium.edu.my/66987/13/66987%20Development%20and%20validation%20of%20a%20novel%20SCOPUS.pdf http://irep.iium.edu.my/66987/7/66987%20Development%20and%20validation%20of%20a%20novel%20general%20medication%20adherence%20scale%20%28GMAS%29%20for%20chronic%20illness%20patients%20in%20Pakistan_wos.pdf |
| Summary: | Objective: 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.
Methods: 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 testretest
reliability, McDonald’s and Pearson correlation coefficient. The factor analyses
were conducted using IBM SPSS version 22 and IBM SPSS AMOS version 25.
Results: 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 (p-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 (p-value < 0.05). Non-comorbid
patients were more likely to be highly adherent as compared to comorbid patients (pvalue
< 0.01).
Conclusion: A novel tool GMAS was developed in Urdu language and was
subsequently validated in patients with chronic diseases. |
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