Revision And Validation Of The Medication Adherence Reasons Scale (MAR–Scale)

Abstract

A7adherence to diabetes medications than the comparison group (p=0.15). After the program, percent adherent grew 29.7% over baseline (p<0.01) net of trends in the comparison group. A smaller impact was observed for cardiovascular medications. Total spending (employer spending plus patient out-of-pocket spending) in the value-based program group was no different than the comparison group (p=0.11). Falsification tests of asthma and migraine medication utilization, showed no significant impact (p>.50). CONCLUSIONS: Results through the first twelve months of the program show that waiving copayments for all family members of a patient with diabetes can improve adherence to diabetes and cardiovascular services, which can lead to improvements in health outcomes.

Medication Adherence: Truth and Consequences

“…Indirect measurements, both subjective and objective, rely on self-reporting such as the Morisky Scale, TABS: Tool for Adherence Behaviour Screening, MAR-scale: Medication Adherence Reasons-scale, pill counts either manually or electronically and increasingly, review of pharmacy refill records such as MedsIndex, MPR. 22 Relying on the latter, especially mail order refills, assumes that because the patient is in possession of the medicine, the medicine is being taken. This results in overestimation of adherence.…”

Patient‐reported outcome instruments that evaluate adherence behaviours in adults with asthma: a systematic review of measurement properties

“…These studies were published between 1994 and 2017. Fourteen PROs were identified: (i) the Adult Asthma Adherence Questionnaire (AAAQ) ; (ii) the Adherence Questionnaire ; (iii) the Asthma Diary ; (iv) the 20‐item Adherence Starts with Knowledge (ASK‐20) ; derived from the Self‐Reported Medication‐Taking Scale (SRMTS, also referred to as the Morisky ‐Green): (v) the Inhaler Adherence Scale (IAS) ; (vi) the 15‐item Medication Adherence Reasons (MAR) Scale) ; (vii) the 20‐item or refined MAR scale ; (viii) the Medication Adherence Report Scale for Asthma (MARS‐A) ; also derived from the SRMTS : (ix) the Medication Adherence Scale (MAS) ; (x) the Medication Intake Survey–Asthma (MIS‐A) ; (xi) the Patterns of Asthma Medication Use Questionnaire (PAMUQ) ; (xii) the Questions of Interest (QIs) ; (xiii) an unnamed PRO ; and (xiv) the Test of the Adherence to Inhalers (TAI) .…”

“…The internal consistency was assessed, using Cronbach's alphas, in nine studies of either fair or poor methodological quality . Methodological quality was lowered because there was no description of how missing items were handled or because no factor analysis was used to check the unidimensionality of the scales.…”

“…The structural validity of the AAAQ , the Adherence Questionnaire , the MAR scale , the refined MAR scale , the MARS‐A and the TAI was reported. In four studies of fair methodological quality , factor(s) explained at least 50% of the variance, which suggested a limited level of evidence regarding the structural validity of the Adherence Questionnaire , the MAR scale , the MARS‐A and the TAI .…”

“…Nine studies reported assessing the criterion validity of their PRO. Three studies of fair methodological quality relied on electronic monitoring as gold standards.…”