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The Malaysian Medication Adherence Scale (MALMAS): Concurrent Validity Using a Clinical Measure among People with Type 2 Diabetes in Malaysia

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  • Wen Wei Chung
  • Siew Siang Chua
  • Pauline Siew Mei Lai
  • Donald E Morisky

Abstract

Medication non-adherence is a prevalent problem worldwide but up to today, no gold standard is available to assess such behavior. This study was to evaluate the psychometric properties, particularly the concurrent validity of the English version of the Malaysian Medication Adherence Scale (MALMAS) among people with type 2 diabetes in Malaysia. Individuals with type 2 diabetes, aged 21 years and above, using at least one anti-diabetes agent and could communicate in English were recruited. The MALMAS was compared with the 8-item Morisky Medication Adherence Scale (MMAS-8) to assess its convergent validity while concurrent validity was evaluated based on the levels of glycated hemoglobin (HbA1C). Participants answered the MALMAS twice: at baseline and 4 weeks later. The study involved 136 participants. The MALMAS achieved acceptable internal consistency (Cronbach’s alpha=0.565) and stable reliability as the test-retest scores showed fair correlation (Spearman’s rho=0.412). The MALMAS has good correlation with the MMAS-8 (Spearman’s rho=0.715). Participants who were adherent to their anti-diabetes medications had significantly lower median HbA1C values than those who were non-adherence (7.90 versus 8.55%, p=0.032). The odds of participants who were adherent to their medications achieving good glycemic control was 3.36 times (95% confidence interval: 1.09-10.37) of those who were non-adherence. This confirms the concurrent validity of the MALMAS. The sensitivity of the MALMAS was 88.9% while its specificity was 29.6%. The findings of this study further substantiates the reliability and validity of the MALMAS, in particular its concurrent validity and sensitivity for assessing medication adherence of people with type 2 diabetes in Malaysia.

Suggested Citation

  • Wen Wei Chung & Siew Siang Chua & Pauline Siew Mei Lai & Donald E Morisky, 2015. "The Malaysian Medication Adherence Scale (MALMAS): Concurrent Validity Using a Clinical Measure among People with Type 2 Diabetes in Malaysia," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-11, April.
    • Handle: RePEc:plo:pone00:0124275
    DOI: 10.1371/journal.pone.0124275
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    References listed on IDEAS

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    1. Wen‐Wen Li & Chi‐Tai Kuo & Shiow‐Li Hwang & Hsin‐Tien Hsu, 2012. "Factors related to medication non‐adherence for patients with hypertension in Taiwan," Journal of Clinical Nursing, John Wiley & Sons, vol. 21(13-14), pages 1816-1824, July.
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    Cited by:

    1. Ernieda Hatah & Nadiah Rahim & Mohd Makmor-Bakry & Noraida Mohamed Shah & Noraini Mohamad & Mahadir Ahmad & Nor Hasni Haron & Choe Sze Hwe & Angeline Tan Meng Wah & Fahmi Hassan & Shakirin Shaik Rahma, 2020. "Development and validation of Malaysia Medication Adherence Assessment Tool (MyMAAT) for diabetic patients," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-17, November.
    2. Sheron Sir Loon Goh & Pauline Siew Mei Lai & Su-May Liew & Kit Mun Tan & Wen Wei Chung & Siew Siang Chua, 2020. "Development of a PATIENT-Medication Adherence Instrument (P-MAI) and a HEALTHCARE PROFESSIONAL-Medication Adherence Instrument (H-MAI) using the nominal group technique," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-18, November.
    3. Hardesh Dhillon & Rusli Bin Nordin & Amutha Ramadas, 2019. "Quality of Life and Associated Factors among Primary Care Asian Patients with Type 2 Diabetes Mellitus," IJERPH, MDPI, vol. 16(19), pages 1-12, September.

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