IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0158499.html
   My bibliography  Save this article

Validity and Reliability of a Self-Reported Measure of Antihypertensive Medication Adherence in Uganda

Author

Listed:
  • Samson Okello
  • Benson Nasasira
  • Anthony Ndichu Wa Muiru
  • Anthony Muyingo

Abstract

Background: The Morisky Medication Adherence scale (MMAS-8) is a widely used self-reported measure of adherence to antihypertensive medications that has not been validated in hypertensive patients in sub-Saharan Africa. Methods: We carried out a cross-sectional study to examine psychometric properties of a translated MMAS-8 (MMAS-U) in a tertiary care hypertension clinic in Uganda. We administered the MMAS-U to consecutively selected hypertensive adults and used principal factor analysis and Cronbach’s alpha to determine its validity and internal consistency respectively. Then we randomly selected one-sixth of participants for a 2-week test-retest telephone interview. Lastly, we used ordinal logistic regression modeling to explore factors associated with levels of medication adherence. Results: Of the 329 participants, 228 (69%) were females, median age of 55 years [Interquartile range (IQR) (46–66)], and median duration of hypertension of 4 years [IQR (2–8)]. The adherence levels were low (MMAS-U score ≤ 5) in 85%, moderate (MMAS-U score 6–7) in 12% and high (MMAS-U score ≥8) in 3%. The factor analysis of construct validity was good (overall Kaiser’s measure of sampling adequacy for residuals of 0.72) and identified unidimensionality of MMAS-U. The internal consistency of MMAS-U was moderate (Cronbach α = 0.65), and test-retest reliability was low (weighted kappa = 0.36; 95% CI -0.01, 0.73). Age of 40 years or greater was associated with low medication adherence (p = 0.02) whereas a family member buying medication for participants (p = 0.02) and purchasing medication from a private clinic (p = 0.02) were associated with high adherence. Conclusion: The Ugandan version of the MMAS-8 (MMAS-U) is a valid and reliable measure of adherence to antihypertensive medication among Ugandan outpatients receiving care at a public tertiary facility. Though the limited supply of medication affected adherence, this easy to use tool can be adapted to assess medication adherence among adults with hypertension in Uganda.

Suggested Citation

  • Samson Okello & Benson Nasasira & Anthony Ndichu Wa Muiru & Anthony Muyingo, 2016. "Validity and Reliability of a Self-Reported Measure of Antihypertensive Medication Adherence in Uganda," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-11, July.
    • Handle: RePEc:plo:pone00:0158499
    DOI: 10.1371/journal.pone.0158499
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158499
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0158499&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0158499?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Koning, A.J. & Franses, Ph.H.B.F., 2003. "Confidence Intervals for Cronbach's Coefficient Alpha Values," ERIM Report Series Research in Management ERS-2003-041-MKT, Erasmus Research Institute of Management (ERIM), ERIM is the joint research institute of the Rotterdam School of Management, Erasmus University and the Erasmus School of Economics (ESE) at Erasmus University Rotterdam.
    2. Shea, S. & Misra, D. & Ehrlich, M.H. & Field, L. & Francis, C.K., 1992. "Correlates of nonadherence to hypertension treatment in an inner-city minority population," American Journal of Public Health, American Public Health Association, vol. 82(12), pages 1607-1612.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Leontitsis, Alexandros & Pagge, Jenny, 2007. "A simulation approach on Cronbach's alpha statistical significance," Mathematics and Computers in Simulation (MATCOM), Elsevier, vol. 73(5), pages 336-340.
    2. Arana-Solares, Iván Andrés & Ortega-Jiménez, César H. & Alfalla-Luque, Rafaela & Pérez-Díez de los Ríos, José Luis, 2019. "Contextual factors intervening in the manufacturing strategy and technology management-performance relationship," International Journal of Production Economics, Elsevier, vol. 207(C), pages 81-95.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0158499. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.