Scales for assessing medication adherence in patients with hypertension

Abstract

Background: the choice of the appropriate tool for assessing level of medication adherence is a significant barrier in scientific research. Aims: to translate into Greek and test the reliability of the Hill-Bone and A-14 scales among patients with hypertension. Also, to compare patients' responses in the Hill-Bone scale, A-14 scale and Morisky Medication Adherence Scale (MMAS). Methods: data collection occurred between February 2016 and March 2016 at a general hospital in Athens, Greece. The sample consisted of hypertensive patients (n=34) and non-hypertensive patients (n=34). Findings: the coefficient alpha in hypertensive patients was 0.76 for Hill-Bone, 0.64 for MMAS and 0.91 for the A-14 scale. In non-hypertensive patients, the Cronbach's alpha for MMAS was 0.81 and 0.78 for A-14. A statistically significant difference was found among the mean scores of the scales, whereas strong correlation was found only between two pairs of questions with similar meaning. Conclusion: all tools are appropriate to assess the level of medication adherence in Greek hypertensive patients. However, careful translation of the scales is essential since items with the same meaning could be understudied in a different way.

Validity and reliability of the Romanian version of the Hill-Bone compliance to high blood pressure therapy scale

“…The original Hill-Bone Compliance to High Blood Pressure Therapy Scale tool has been used in many studies and it has been translated into several languages. These studies evaluated the extent to which it measures adherence to treatment and proved that the Hill-Bone compliance to High Blood Pressure Therapy Scale has a good content validity ( Karademir et al, 2009 ; Nogueira-Silva et al, 2016 ; Uchmanowicz et al, 2016 ; Chatziefstratiou et al, 2019 ). Nevertheless, to maintain the content validity of the Romanian version of the Hill-Bone Compliance to High Blood Pressure Therapy Scale, the translation of the tool was analyzed by an expert panel.…”

“…Developed by the School of Nursing from the John Hopkins University in 1999, the 14-item instrument is used to assess adherence levels, while also capturing aspects related to salt reduction and keeping up with appointments ( Chia et al, 2021 ), connecting with the three identified behavioral domains of adherence: 1) reducing sodium intake; 2) appointment keeping; 3) medication taking ( Kim et al, 2000 ). There are several translated and validated versions of this scale in different languages, such as Chinese ( Pan et al, 2020 ), Greek ( Chatziefstratiou et al, 2019 ), Polish ( Uchmanowicz et al, 2016 ), Namibian ( Nashilongo et al, 2017 ) as well as Turkish ( Karademir et al, 2009 ), which highlights the fact that many behavioral aspects are measurable across cultures ( Culig and Leppée, 2014 ). The aim of our study is to take the appropriate steps for the translation, adaptation and validation of this instrument so that it can be used by professionals such as pharmacists or physicians in Romania, since this has not been previously done.…”

A Systematic Review of the Hill-Bone Compliance to Blood Pressure Therapy Scale

“… Mean score: 24.16; Median score: 25.0. Boulware et al, 2009 23 USA Cross-sectional 195 HTN Adults from 15 primary care practices 51% were 60+ English Full scale (14 items) Interview Scores range from 14–56 points, Higher scores indicating poorer adherence Cronbach α= NR Mean(±SD) Score: 17.8 (±2.6), Range 14–26 Chatziefstratiou et al, 2019 24 Greece Methodolo-gical study 68 HTN Patients with and without HTN at a general hospital Mean: 65 Greek Full scale Self-administration 4-point Likert-type scale (4=all the time; 1=never) Cronbach’s α = 0.76 Cheong et al, 2015 25 Malaysia Cross-sectional; instrument validity 262 HTN Adults from two public primary healthcare clinics Mean (±SD) age: 56.3 (±8.7) Malay, but responses were in Chinese/Tamil/Malay Full scale (14 items) Self-administration 4-point Likert scale. Scores ranged from 1 (all the time) −4 (none of the time).…”

Effect of eTansiyon smartphone application on hypertension control

“…• Increase adherence to treatment: MMAS-8 (Morisky, Green and Levine, 1986) was used. MMAS-8 scale was found to be appropriate to assess level of medication adherence (Chatziefstratiou et al, 2019) Those who scored '0' were considered as 'highly adherent', 1-2 a 'moderately adherent' and 3-8 as 'low adherent'. website (Framingham Heart Study, 2018).…”