Development of a Taiwan Version of the Eight-item Morisky Medication Adherence Scale and Factors Influencing Patients' Comprehension

ObjectiveIn Taiwan, patients' low adherence to medication needs immediate attention and rectification. This study was intended to evaluate patients' capability in comprehending a Mandarin- and Taiwanese-language Taiwan version of the eight-item Morisky Medication Adherence Scale (MMAS-8), and to explore the possible factors influencing patients' ability to understand.MethodsSixty-five participants, recruited from the neurology clinics of two Taipei Medical University-affiliated hospitals, received semi-structured, one-on-one, in-depth interviews (using the Taiwan version of the MMAS-8 combined with open questions to ask the patients what they had heard and what their opinion was on the Taiwan version of the MMAS-8). A cross-sectional survey method was used to analyze the data. The original Taiwan version of the MMAS-8 was then modified according to the patients' and experts' opinion and was validated by expert review.ResultsLower comprehension of the response choices was related significantly to (1) age over 65 years (p < 0.05), (2) education lasting less than 12 years (p < 0.05), and (3) complex comorbid conditions (p < 0.05). Many patients were confused by the dichotomous response choices in Question 1 to 7 and the wordings of Questions 2 and 8 of the original version of the Taiwan MMAS-8. Therefore, these were modified into more specified sentences according to patients' and experts' suggested opinion.ConclusionThe modified Taiwan version of the eight-item MMAS was validated by experts. Future research is needed to validate its psychometric properties.