<p>Development of the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) Medication Adherence Scale (PMAS)</p>

Abstract

Poor medication adherence is associated with reduced drug effectiveness, poor health-related quality of life, increased morbidity and mortality, and increased healthcare utilization and cost. Including the patient's voice is essential in understanding barriers to adherence. Useful patient-reported adherence measures are brief, inexpensive, noninvasive; can indicate barriers to adherence; and can be incorporated in electronic health records. The NIH Patient-Reported Outcomes Measurement Information System (PROMIS ® ) includes high-quality, freely available patient-reported measures covering many important constructs in patient-centered research but does not include a medication adherence measure. To fill this gap, we developed the PROMIS Medication Adherence Scale (PMAS) using the rigorous PROMIS instrument development guidelines. To develop the PMAS, we first conducted a review of the reviews, which enabled us to identify content areas relevant to medication adherence behavior. Then, we conducted qualitative research to elicit patients' views of and experiences with medication adherence. This process identified the following important content areas to guide item writing: extent medication is taken, knowledge of medication regimen, beliefs about medication, remembering to take medication, skipping due to side effects, skipping due to feeling better, and cost of medications. Based on the results of these activities, we wrote items and aimed to retain 1-2 items per content area. The final item set included 9 total adherence items, which were then refined through intensive comprehension and translatability review, as well as cognitive interviews. Future steps include testing the PMAS's validity.

A Systematic Review of Adherence to Immunosuppression among Pediatric Heart Transplant Patients

“…It is worth noting that recent efforts led to the development of the PROMIS Medication Adherence Scale (PMAS), which is a widely available, free self-report measure of adherence. Validation studies for PMAS are ongoing to evaluate its psychometric properties in different pediatric and adult patient populations [ 29 ].…”

Development and validation of the Methotrexate Experience Questionnaire, a new methotrexate oral treatment adherence tool in rheumatoid arthritis

“…Nonetheless, the original 24-item MEQ is key to inform in-depth discussion between physicians and patients. Shorter generic or RA-specific questionnaires exist and may be used to capture adherence, such as the MMAS [ 8 ], MARS [ 9 ], or the newly developed NIH Patient-Reported Outcomes Measurement Information System (PROMIS) Medication Adherence Scale (PMAS) [ 26 ], however the MEQ shall be used beyond the assessment of the adherence of patients taking MTX in RA and shall be used in daily medical practice to discuss specifics linked to MTX and allow for better-informed joint treatment decisions between physicians and their patients.…”

Clinical trial considerations in sickle cell disease: patient-reported outcomes, data elements, and the stakeholder engagement framework

“…It is worth not ing that recent col lab o ra tive, mul ti dis ci plin ary efforts led to the devel op ment of the PROMIS Med ication Adherence Scale (PMAS), and its psy cho met ric eval u a tion is under way in sev eral ongo ing tri als. 30 PMAS is listed in CureSCi's com mon data ele ments (CDEs). Given that both objec tive and sub jec tive mea sures of adher ence have the poten tial to cap ture var i ous aspects of med i ca tiontak ing behav ior, a mul ti modal strat egy is highly recommended.…”