Validation of an Arabic Version of the Adherence to Refills and Medications Scale (ARMS)

Abstract

Background: Medication non-adherence is a complex multifactorial phenomenon impacting patients with various health conditions worldwide. Therefore, its detection can improve patient outcomes and minimize the risk of adverse consequences. Even though multiple self-reported medication adherence assessment scales are available, very few of them exist in Arabic language. Therefore, the aim of this study was to validate a newly translated Arabic version of the Adherence to Refills and Medications Scale (ARMS) among patients with chronic health conditions. Methods: This is a single-center cross-sectional study that was conducted between October 10th 2018 and March 23rd 2021. ARMS was first translated to Arabic using the forward-backward translation method. The translated scale was then piloted among 21 patients with chronic health conditions (e.g., diabetes, hypertension, etc.…) to examine its reliability and comprehensibility using the test-retest method. Thereafter, the Arabic-translated ARMS was self-administered to adult patients aged ≥18 years with chronic health conditions visiting the primary care clinics of a university-affiliated tertiary care hospital in Riyadh, Saudi Arabia. Construct validity was examined using factor analysis with varimax rotation. Results: Of the 264 patients who were invited to participate, 202 (76.5%) consented and completed the questionnaire. Most of the participants were males (69.9%), married (75.2%), having a college degree or higher (50.9%), retired or unemployed (65.2%), aged ≥ 50 years (65.2%), and are diabetic (95.9%). The 12-item Arabic-translated ARMS mean score was 17.93 ± 4.90, and the scale yielded good internal consistency (Cronbach’s alpha = 0.802) and test-retest reliability (Intraclass correlation coefficient = 0.97). Two factors were extracted explaining 100% of the of the total variance (factor 1 = 52.94% and factor 2 = 47.06%). Conclusions: The 12-item Arabic version of ARMS demonstrated good validity and reliability. Therefore, it should help in the detection of medication non-adherence among Arabic-speaking patient population and minimize the risk of adverse consequences.

Measurement Properties of Patient-Reported Outcome Measures for Medication Adherence in Cardiovascular Disease: A COSMIN Systematic Review

“…Of the 35 studies that evaluated the content validity of an existing MA-PROM, 21 involved only patients [ 42 , 44 , 47 , 52 , 55 , 59 , 61 , 62 , 68 , 70 , 72 , 75 , 76 , 79 , 84 , 88 , 90 , 99 , 109 , 115 , 131 ], 4 involved only experts [ 67 , 89 , 103 , 124 ], and 10 involved both patients and experts [ 46 , 54 , 63 , 64 , 73 , 74 , 86 , 108 , 117 , 123 ] (Table 4 ). No studies that were not development studies were found on content validity for 21 of the identified MA-PROMs [ 45 , 50 , 51 , 56 , 60 , 66 , 71 , 78 , 80 , 85 , 91 – 93 , 96 , 97 , 105 , 110 , 113 , 119 – 121 , 125 ].…”

Ruxolitinib Adherence in Myelofibrosis and Polycythemia Vera: the “RAMP” Italian multicenter prospective study

“…Different ARMS cut-off values have been used in different cohorts to categorize patients according to low and high adherence [27][28][29]. For the purpose if this study, the cut-off value of 14 was selected as it was the mean ARMS score in our cohort.…”

Medication Non-Adherence among Patients with Chronic Diseases in Makkah Region

“…ARMS is a 12-item medication adherence assessment tool with established validity and reliability in English and was published in 2009 by Dr. Kripalani and his colleagues [ 22 ]. It was translated and validated after that into many languages among patients with chronic health conditions [ 23 ]. It was translated and validated recently to the Arabic language among Saudi patients [ 23 ], which makes it a good and suitable survey for our study.…”

“…It was translated and validated after that into many languages among patients with chronic health conditions [ 23 ]. It was translated and validated recently to the Arabic language among Saudi patients [ 23 ], which makes it a good and suitable survey for our study. This scale could be easily completed by patients in a short time (less than 15 min).…”