Retracted: Predictive Validity of a Medication Adherence Measure in an Outpatient Setting

Morisky, Donald E.; Ang, Alfonso; Krousel‐Wood, Marie; Ward, Harry J.

doi:10.1111/j.1751-7176.2008.07572.x

Cited by 2,599 publications

(2,696 citation statements)

References 47 publications

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“…Medication adherence was assessed by the 8-item Morisky Medication Adherence Scale (MMAS-8) in Section II of the questionnaire [21]. The MMAS-8 is a simple, reliable, and widely used instrument for determining adherence to prescribed medications [22].…”

Section: Methodsmentioning

confidence: 99%

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Liu

Farazi

et al. 2018

Global Health Action

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Background: Globally, of the 248 million people chronically infected with the hepatitis B virus (HBV), 74 million reside in China. Five oral nucleot(s)ide analogs (NUCs) have been approved for the treatment of chronic hepatitis B (CHB) in China. Objectives: The aims of this study were to determine rates of adherence to NUC therapy in patients with CHB, to identify the self-perceived barriers to adherence, and to examine the factors associated with adherence. Methods: Questionnaire-based interviews were administered among Chinese patients with CHB at hepatology clinics of a tertiary hospital in the city of Wuhan, China. Adults aged 18 years or older prescribed with NUCs were recruited and interviewed to complete a 27-item questionnaire in a private setting, and adherence was measured using the Morisky Medication Adherence Scale (MMAS-8). Results: Among 369 participants, only 16.5% had high adherence (score of 8), 32.2% had medium adherence (score of 6 to <8), and 51.2% were measured with low adherence (score of <6). A logistic regression model was used to determine the factors associated with medication adherence. Significant predictors of high adherence consisted of urban residency, non-cirrhotic status, not using prescribed pills other than HBV medications, and reminders from family members. The five most common reasons for skipping NUCs were that medication(s) are expensive (48.7%), forgetfulness (45.1%), have experienced or worry about potential side effects (19.8%), do not want others to know about my medication(s) usage (18.5%), and ran out of pills and do not have time to refill (15.9%). Conclusions: This study revealed that adherence rates to oral antiviral therapy were far from optimal. This finding should generate public attention, and it would be beneficial for interventional programs to target Chinese patients from rural regions, as well as patients with low socioeconomic status, cirrhosis, and taking multiple medications.

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Section: Methodsmentioning

confidence: 99%

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Liu

Farazi

et al. 2018

Global Health Action

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“…Area‐level poverty and health insurance are enabling factors but were examined as exposure variables for vulnerability domains. Perceived need included medication adherence, assessed by Morisky's 4‐item scale15 (any affirmative response indicated nonadherence), and awareness of hyperlipidemia (having been told about high cholesterol by a healthcare provider). Evaluated need‐related factors included current smoking; depressive symptoms, as assessed using the 4‐item Center for Epidemiologic Studies‐Depression Scale with a score ≥416; high‐density lipoprotein cholesterol <50 mg/dL for women and <40 mg/dL for men; body mass index >30; physical functioning, as reflected in the Medical Outcomes Study Short Form 12 Physical Component Summary (PCS) score as a measure of illness burden17; and CHD risk category (per ATP III guidelines: history of cardiovascular disease or risk equivalent; FRS >20%, 10–20%, or <10%).…”

Section: Methodsmentioning

confidence: 99%

Vulnerabilities to Health Disparities and Statin Use in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study

Schroff

Gamboa

Durant

et al. 2017

JAHA

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BackgroundStatins may be underutilized in certain vulnerable populations, but the effect of cumulative vulnerabilities within 1 individual is not well described. We sought to determine the likelihood of receiving statins with an increasing number of vulnerabilities in an individual, after controlling for factors known to influence health services utilization.Methods and ResultsWe identified 18 216 participants from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study who had a statin indication or who were taking statins, as verified by pill bottle review. Statin use was assessed with respect to 5 major vulnerability domains alone and in combination: older age, black race, female sex, high area‐level poverty, and lack of health insurance. The study included 5286 white men, 4180 black men, 2791 white women, and 4194 black women; 5.6% of the sample had no vulnerabilities, 20.6% had 1 vulnerability, 29.2% had 2 vulnerabilities, 27.3% had 3 vulnerabilities, and 17.3% had 4 or 5 vulnerabilities. All race–sex groups were less likely than white men to use statins; prevalence of use was 0.80 in black women with reference to white men (P<0.0001). In both unadjusted and adjusted models, as the number of vulnerabilities increased, statin use steadily decreased. After adjusting for factors that influence health services utilization, compared with those without any vulnerabilities, statin use prevalence was 0.91, 0.83, 0.74 and 0.68 (P<0.0001) in those with 1, 2, 3, and 4 or 5 vulnerabilities, respectively.ConclusionsParticipants with more simultaneously occurring vulnerabilities experienced the greatest disparities in statin use. Black women and those without health insurance were at particularly high risk of underutilization.

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“…There are also a number of validated adherence assessment tools that could be implemented in clinical practice including the Adherence Starts with Knowledge-12 (ASK-12),66 the Brief Adherence Rating Scale (BARS),67 and the eight-item Morisky Medication Adherence Scale 68. Each tool is accessible on the Internet and relatively easy to administer.…”

Section: Interventions To Support Adherencementioning

confidence: 99%

The Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals

Richmond¹,

Sheppard‐Law²,

Mason³

et al. 2016

PPA

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BackgroundHepatitis C is a blood-borne virus primarily spread through sharing of drug-injecting equipment. Approximately 150 million people worldwide and 230,000 Australians are living with chronic hepatitis C infection. In March 2016, the Australian government began subsidizing direct acting antivirals (DAAs) for the treatment of hepatitis C, which are highly effective (95% cure rate) and have few side effects. However, there is limited evidence to inform the provision of adherence support to people with hepatitis C on DAAs including the level of medication adherence required to achieve a cure.MethodologyIn February 2016, a steering committee comprising four authors convened an expert panel consisting of six hepatology nurses, a hepatologist, a pharmacist, a consumer with hepatitis C and treatment experience, and a consumer advocate. The expert panel focused on the following criteria: barriers and enablers to DAA adherence; assessment and monitoring of DAA adherence; components of a patient-centered approach to DAA adherence; patients that may require additional adherence support; and interventions to support DAA adherence. The resultant guidelines underwent three rounds of consultation with the expert panel, Australasian Hepatology Association (AHA) members (n=12), and key stakeholders (n=7) in June 2016. Feedback was considered by the steering committee and incorporated if consensus was achieved.ResultsTwenty-four guidelines emerged from the evidence synthesis and expert panel discussion. The guidelines focus on the pretreatment assessment and education, assessment of treatment readiness, and monitoring of medication adherence. The guidelines are embedded in a patient-centered approach which highlights that all patients are at risk of nonadherence. The guidelines recommend implementing interventions focused on identifying patients’ memory triggers and hooks; use of nonconfrontational and nonjudgmental language by health professionals; and objectively monitoring adherence.ConclusionThese are the first guidelines to support patients and health professionals in the delivery of clinical care by identifying practical adherence support interventions for patients taking DAAs.

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Retracted: Predictive Validity of a Medication Adherence Measure in an Outpatient Setting

Cited by 2,599 publications

References 47 publications

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Vulnerabilities to Health Disparities and Statin Use in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study

The Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals

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