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Translation and validation study of Morisky Medication Adherence Scale (MMAS): the Urdu version for facilitating person-centered healthcare in Pakistan

Fahad Saleem, Mohamed Azmi Hassali, Shafie Akmal, Donald E. Morisky, Muhammad Atif, Harith Kh Al-Qazaz, Imran Masood, Noman ul Haq, Hisham Aljadhey, Maryam Farooqui

Abstract


Objective: The study aims to translate and examine the psychometric properties of the Urdu version of Morisky Medication Adherence Scale (MMAS) among hypertensive patients in Quetta, Pakistan.

Method: A standard ‘‘forward–backward’’ procedure of translation was used to translate the English version of MMAS into Urdu. The translated version was than validated on a convenience sample of 150 hypertensive patients attending a public hospital in Quetta, Pakistan, between July and September 2010. The reliability of the translated questionnaire was tested for internal consistency. Validity was confirmed using convergent and known group validity.

Results: Adopting the recommended scoring method, the mean ± SD of MMAS scores was 6.23 ± 0.9. The instrument demonstrated good internal consistency (Cronbach’s a = 0.701). The test–retest reliability value was 0.8 (p < 0.001). A positive correlation between the 8 and 4 item MMAS was found (r = 0.765; p ≤ 0.01). There was a significant relationship between MMAS categories and the hypertension control groups (χ2 = 19.996; p < 0.001). The MMAS sensitivity and specificity, with positive and negative predictive values, were 46.15%, 60.00%, 45.0% and 61.11%, respectively.

Conclusions: Results from this translation and validation study conclude that the Urdu version of the MMAS is a reliable and valid measure of medication adherence and therefore a valid tool for the advancement of person-centered healthcare.


Keywords


Adherence, adherence scale, Morisky Medication, person-centered healthcare, translation, Urdu, validation

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References


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DOI: http://dx.doi.org/10.5750/ijpcm.v2i3.251

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