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Title: Psychometric properties of the 8-item Morisky Medication Adherence Scale in patients taking warfarin
Authors: Wang, Y.
Kong, M.C.
Ko, Y. 
Keywords: Anticoagulation
Medication adherence
Morisky medication adherence scale
Issue Date: Sep-2012
Citation: Wang, Y., Kong, M.C., Ko, Y. (2012-09). Psychometric properties of the 8-item Morisky Medication Adherence Scale in patients taking warfarin. Thrombosis and Haemostasis 108 (4) : 789-795. ScholarBank@NUS Repository.
Abstract: There is no patient-reported medication adherence measure that has been validated in Singapore. This study aimed to validate the 8-item Morisky Medication Adherence Scale (MMAS) in patients taking warfarin in Singapore. A cross-sectional survey was conducted in a convenience sample of 151 patients taking warfarin at an anticoagulation clinic in 2011. Respondents completed the MMAS in English or Chinese depending on their preference. The MMAS had a Cronbach's alpha of 0.56 and good criterion-related validity as the scale scores were associated with warfarin refill rates (p = 0.04). Respondents with higher MMAS scores were found to have a higher percentage of International Normalised Ratios (INRs) within the therapeutic range (p = 0.01), higher adherence to diet recommendations (p = 0.02), and less perceived difficulty in taking all medications (p < 0.001); they were also more likely to take warfarin at the same time every day (p < 0.001). Confirmatory factor analysis showed that the eight items loaded onto one factor (RMSEA = 0.03). The sensitivity, specificity, positive predictive value and negative predictive value of the MMAS for identifying patients with poor INR control were 73.0%, 35.6%, 49.5% and 60.5%, respectively, using the time in the therapeutic INR range as the gold standard. This study shows that the 8-item MMAS has good validity and moderate reliability in patients taking warfarin. Future research is needed to investigate the scale's psychometric properties in other patient populations and clinical settings. © Schattauer 2012.
Source Title: Thrombosis and Haemostasis
ISSN: 03406245
DOI: 10.1160/TH12-05-0368
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