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Emerging Technologies, Pharmacology and Therapeutics
Validity and reliability of anti-diabetic medication adherence scale among patients with diabetes in Baghdad, Iraq: a pilot study
  1. Ehab Mudher Mikhael1,2,
  2. Saad A Hussain3,
  3. Nizar Shawky4,
  4. Mohamed Azmi Hassali2
  1. 1Clinical Pharmacy Department, College of Pharmacy, University of Baghdad, Baghdad, Iraq
  2. 2Department of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
  3. 3School of Pharmacy, Al-Rafidain University College, Baghdad, Iraq
  4. 4National Diabetes Center, Al-Mustansiriyah University, Baghdad, Iraq
  1. Correspondence to Dr Ehab Mudher Mikhael; ehab_pharma84{at}yahoo.com

Abstract

Background Medication non-adherence is a common problem among patients with diabetes. Patient-reported medication adherence scales are the most commonly used method to assess patient medication adherence, but up to today there is no specific tool for assessing medication adherence among patients with diabetes in Arab countries. This study aimed to develop and validate a new tool for assessment of adherence to antidiabetic medications among Iraqi patients with diabetes.

Methods The Iraqi Anti-Diabetic Medication Adherence Scale (IADMAS) consists of eight items. The face and content validity of the IADMAS were established via an expert panel. For convergent validity, the IADMAS was compared with the Medication Adherence Questionnaire (MAQ). For concurrent validity, the IADMAS was compared with glycosylated hemoglobin. A total of 84 patients with types 2 diabetes were recruited from a diabetes center in Baghdad, Iraq. Test–retest reliability was measured by readministering the IADMAS to the same patients 4 weeks later.

Results Only 80 patients completed the study (response rate: 95%). Reliability analysis of the IADMAS showed a Cronbach’s alpha value of 0.712, whereas that of the MAQ was 0.649. All items in the IADMAS showed no significant difference in the test–retest analysis, indicating that the IADMAS has stable reliability. There was no difference in the psychometric properties of the IADMAS and the MAQ. The sensitivity and specificity of the IADMAS were higher than that of the MAQ (100% vs 87.5% and 33.9% vs 29.7%, respectively).

Conclusion The IADMAS developed in this study is a reliable and valid instrument for assessing antidiabetic medication adherence among Iraqi patients.

  • anti-diabetic drugs
  • medication adherence

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2019-000658

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    Footnotes

    • Contributors EMM was involved in presenting the research idea, literature review, developing the Iraqi Anti-Diabetic Medication Adherence Scale, data collection, statistical analysis and writing the manuscript. SAH was responsible for revising the research and the Iraqi Anti-Diabetic Medication Adherence Scale. NS was responsible for revising the Iraqi Anti-Diabetic Medication Adherence Scale and data collection. MAH was responsible for revising the research.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Ethical approval for this study was obtained from the ethical committee at the National Diabetes Center.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data availability statement All data were presented in this article.