Translation, Cultural Adaptation and Validation of General Medication Adherence Scale (GMAS) into the Nepalese Language

Rajeev Shrestha, Binaya Sapkota, Asmita Priyadarshini Khatiwada, Sunil Shrestha, Saval Khanal, Bhuvan Kc, Vibhu Paudyal, Rajeev Shrestha, Binaya Sapkota, Asmita Priyadarshini Khatiwada, Sunil Shrestha, Saval Khanal, Bhuvan Kc, Vibhu Paudyal

Abstract

Background: The General Medication Adherence Scale (GMAS) evaluates intentional and unintentional behaviour of patients, disease and medication burden and cost-related burden associated with non-adherence. GMAS was developed and validated among Urdu-speaking patients with chronic diseases. However, validated tool in Nepalese language to measure medication adherence among chronic illness patients currently does not exist.

Aim: To translate, culturally adapt, and validate the English version of GMAS into the Nepalese language to measure medication adherence among chronic illness patients.

Methods: The study was conducted among patients with chronic diseases in both hospital and community pharmacies of Nepal. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Good Practice Guideline for linguistic translation and cultural adaptation was used to translate and culturally adapt the English version of GMAS into the Nepalese version. The translated version was validated amongst patients with chronic diseases in Nepal. Exploratory factor analysis was carried out using principal component analysis with varimax rotation. Test-retest reliability and internal consistency were analysed.

Results: A total of 220 (53.6% females, and 51.4% of 51 to 70 aged patients) patients with chronic diseases participated in the study. The majority of patients took two medications (27.3%) from six months to five and half years (68.2%). Kaiser Meyer Olkin was found to be 0.83. A principal axis factor analysis was conducted on the 3 items of GMAS without and with orthogonal rotation (varimax). The scree plot showed an inflexion on the third item that meant three components were present. The overall Cronbach's alpha value of the full-phase study was 0.82.

Conclusion: The General Medication Adherence Scale was successfully translated into the Nepalese language, culturally adapted, and validated amongst chronic diseases patients of Nepal. Therefore, the GMAS-Nepalese version can be used to evaluate medication adherence among Nepalese-speaking patients with chronic disease.

Keywords: GMAS; Nepal; adherence; chronic disease; general medication adherence scale; psychometric validation.

Conflict of interest statement

The authors declare that they have no competing interests in this work.

© 2021 Shrestha et al.

Figures

Figure 1
Figure 1
Stepwise translation procedure.

References

    1. World Health Organization. Adherence to long-term therapies; 2003. Available from:. Accessed August5, 2021.
    1. Kim J, Combs K, Downs J, Tillman Ill F. Medication Adherence: The Elephant in the Room. U.S.Pharmacist; 2018. Available from:. Accessed August5, 2021.
    1. Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Interventions for enhancing medication adherence. Cochrane Database Syst Rev. 2008;2. doi:10.1002/14651858.CD000011
    1. Khan A. Non-Communicable Diseases. In: Mastering Community Medicine. Jaypee Brothers Medical Publishers (P) Ltd.; 2010:161. doi:10.5005/jp/books/11410_18
    1. Nepal Health Research Council. Burden of Non-Communicable Diseases in Nepal: An Urgent Need for Actions. Published online 2019. Available from: . Accessed May 5, 2021.
    1. Shrestha R, Pant A, Shrestha S, et al. Study of medication adherence pattern and factors affecting the adherence in chronic obstructive pulmonary disease. Kathmandu Univ Med J. 2015;13(1):64–70. doi:10.3126/kumj.v13i1.13756
    1. Gautam R, Pokharel P. A18646 Adherence to antihypertensive medications among the rural population of Eastern Nepal. J Hypertens. 2018;36:e119–e120. doi:10.1097/01.hjh.0000548479.64171.d2
    1. Shrestha P, Wattanakitkrileart D. Factors influencing medication adherence in Nepalese patients with essential hypertension. Nurs Sci J Thail. 2019;37(3):18–31.
    1. Shakya R, Shrestha S, Gautam R, et al. Perceived illness and treatment adherence to hypertension among patients attending a Tertiary Hospital in Kathmandu, Nepal. Patient Prefer Adherence. 2020;14:2287. doi:10.2147/PPA.S270786
    1. Iuga MM. Adherence and health care costs. Risk Manag Healthc Policy. 2014;7:35. doi:10.2147/RMHP.S19801
    1. Cutler RL, Fernandez-Llimos F, Frommer M, Benrimoj C, Garcia-Cardenas V. Economic impact of medication non-adherence by disease groups: a systematic review. BMJ Open. 2018;8(1):e016982. doi:10.1136/bmjopen-2017-016982
    1. Mongkhon P, Ashcroft DM, Scholfield CN, Kongkaew C. Hospital admissions associated with medication non-adherence: a systematic review of prospective observational studies. BMJ Qual Saf. 2018;27(11):902–914. doi:10.1136/bmjqs-2017-007453
    1. Roebuck MC, Liberman JN, Gemmill-Toyama M, Brennan TA. Medication adherence leads to lower health care use and costs despite increased drug spending. Health Aff. 2011;30(1):91–99. doi:10.1377/hlthaff.2009.1087
    1. Simpson SH, Eurich DT, Majumdar SR, et al. A meta-analysis of the association between adherence to drug therapy and mortality. BMJ. 2006;333(7557):15. doi:10.1136/bmj.38875.675486.55
    1. Kleinsinger F. The unmet challenge of medication nonadherence. Perm J. 2018;22:1–3. doi:10.7812/TPP/18-033
    1. Lehmann A, Aslani P, Ahmed R, et al. Assessing medication adherence: options to consider. Int J Clin Pharm. 2014;36(1):55–69. doi:10.1007/s11096-013-9865-x
    1. Garfield S, Clifford S, Eliasson L, Barber N, Willson A. Suitability of measures of self-reported medication adherence for routine clinical use: a systematic review. BMC Med Res Methodol. 2011;11(1):149. doi:10.1186/1471-2288-11-149
    1. Nguyen T-M-U, La CA, Cottrell N. What are validated self-report adherence scales really measuring?: a systematic review. Br J Clin Pharmacol. 2014;77(3):427–445. doi:10.1111/bcp.12194
    1. Government of nepal M of H and P. Nepal national health accounts 2012/13 to 2015/16. 2018:123. Available from:. Accessed August5, 2021.
    1. Xinhua. COVID-19 could push nearly one-third of Nepal’s population below poverty line: world Bank report – xinhua. . Xinhua; 2020. Available from:. Accessed January25, 2021.
    1. Khanal S, Veerman L, Nissen L, Hollingworth S. Forecasting the amount and cost of medicine to treat type 2 diabetes mellitus in Nepal using knowledge on medicine usage from a developed country. J Pharm Heal Serv Res. 2019;10(1):91–99. doi:10.1111/jphs.12265
    1. Bhandari B, Bhattarai M, Bhandari M, Ghimire A, Pokharel PK, Morisky DE. Adherence to antihypertensive medications: population based follow up in Eastern Nepal. J Nepal Health Res Counc. 2015;13(29):38–42.
    1. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens. 2008;10(5):348–354. doi:10.1111/j.1751-7176.2008.07572.x
    1. Svarstad BL, Chewning BA, Sleath BL, Claesson C. The brief medication questionnaire: a tool for screening patient adherence and barriers to adherence. Patient Educ Couns. 1999;37(2):113–124. doi:10.1016/S0738-3991(98)00107-4
    1. Kripalani S, Risser J, Gatti ME, Jacobson TA. Development and evaluation of the Adherence to Refills and Medications Scale (ARMS) among low-literacy patients with chronic disease. Value Health. 2009;12(1):118–123. doi:10.1111/J.1524-4733.2008.00400.X
    1. Thompson K, Kulkarni J, Sergejew AA. Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophr Res. 2000;42(3):241–247. doi:10.1016/S0920-9964(99)00130-9
    1. Kim MT, Hill MN, Bone LR, Levine DM. Development and testing of the Hill-bone compliance to high blood pressure therapy scale. Prog Cardiovasc Nurs. 2000;15(3):90–96. doi:10.1111/j.1751-7117.2000.tb00211.x
    1. Naqvi AA, Hassali MA. Limitations in contemporary self-reported medication adherence questionnaires: the concept and design of the General Medication Adherence Scale (GMAS) originating from a developing country. Curr Med Res Opin. 2019;35(1):1–2. doi:10.1080/03007995.2018.1526169
    1. Forbes CA, Deshpande S, Sorio-Vilela F, et al. A systematic literature review comparing methods for the measurement of patient persistence and adherence. Curr Med Res Opin. 2018;34(9):1613–1625. doi:10.1080/03007995.2018.1477747
    1. Naqvi AA, Hassali MA, Rizvi M, et al. Development and validation of a novel General Medication Adherence Scale (GMAS) for chronic illness patients in Pakistan. Front Pharmacol. 2018;9:(OCT):1–12. doi:10.3389/fphar.2018.01124
    1. Naqvi AA, Hassali MA, Jahangir A, Nadir MN, Kachela B. Translation and validation of the English version of the general medication adherence scale (GMAS) in patients with chronic illnesses. J Drug Assess. 2019;8(1):36–42. doi:10.1080/21556660.2019.1579729
    1. Shrestha B, Ferdoush Z, Rabbi F, Hossain A. Adherence to medications among Nepali hypertensive population: a hospital-based cross-sectional study. Biomed Res Clin Pract. 2018;3(1):1–4. doi:10.15761/BRCP.1000159
    1. Tan CS, Hassali MA, Neoh CF, Saleem F, Cultural Adaptation HR. Linguistic validation of the beliefs about medicines questionnaire in Malaysia. Value Health Reg Issues. 2018;15:161–168. doi:10.1016/j.vhri.2017.12.010
    1. Shrestha S, Sapkota B, Thapa S, Khanal KCB. Translation, cross-cultural adaptation and validation of Patient Satisfaction with Pharmacist Services Questionnaire (PSPSQ 2.0) into the Nepalese version in a community settings. PLoS One. 2020;15(10):e0240488. doi:10.1371/journal.pone.0240488
    1. Embassy of India K. About India-Nepal relations. Avialable from:. Accessed August5, 2021.
    1. Bolarinwa O. Principles and methods of validity and reliability testing of questionnaires used in social and health science researches. Niger Postgrad Med J. 2015;22(4):195. doi:10.4103/1117-1936.173959
    1. Wild D, Alyson G, Mona M, et al. Principles of good practice for the translation and cultural adaptation process for Patient-Reported Outcomes (PRO) measures. Value Heal. 2005;8(2):95–104.
    1. Conference I, Eighth I, Est R. Kathmandu Metropolitan City, Nepal. 2014. Available from: . Accessed January 25, 2021.
    1. AlQarni K, AlQarni EA, Naqvi AA, et al. Assessment of medication adherence in Saudi patients with Type II diabetes mellitus in Khobar City, Saudi Arabia. Front Pharmacol. 2019:10. doi:10.3389/fphar.2019.01306.
    1. Mir SA, Bhat MU-D, Shakeel D. Self-reported adherence to pharmacotherapy in cancer patients. Int J Basic Clin Pharmacol. 2020;9(6):854. doi:10.18203/2319-2003.ijbcp20202170
    1. Team RC. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2020. Available from:. Accessed August5, 2021.
    1. Costello AB, Osborne JW. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assessment Res Eval. 2005;10:7. doi:10.7275/jyj1-4868
    1. Osborne JW, Costello AB. Sample size and subject to item ratio in principal components analysis. Pract Assessment Res Eval. 2004;9:11. doi:10.7275/ktzq-jq66
    1. Naqvi AA, Mahmoud MA, AlShayban DM, et al. Translation and validation of the Arabic version of the General Medication Adherence Scale (GMAS) in Saudi patients with chronic illnesses. Saudi Pharm J. 2020;28(9):1055–1061. doi:10.1016/j.jsps.2020.07.005
    1. Taber KS. The use of Cronbach’s Alpha when developing and reporting research instruments in science education. Res Sci Educ. 2018;48(6):1273–1296. doi:10.1007/s11165-016-9602-2
    1. IBM Knowledge Center. KMO and Bartlett’s test. Available from:. Accessed August5, 2021.
    1. Kaiser HF. An index of factorial simplicity. Psychometrika. 1974;39(1):31–36. doi:10.1007/BF02291575
    1. Naqvi AA, Hassali MA, Rizvi M, et al. Validation of the general medication adherence scale in Pakistani patients with rheumatoid arthritis. Front Pharmacol. 2020;11(July):1–11. doi:10.3389/fphar.2020.01039
    1. Bryman A, Cramer D. Quantitative Data Analysis with SPSS 12 and 13. Routledge; 2004; doi:10.4324/9780203498187
    1. Nepal Health Research Council (NHRC) Ministry of Health and Population (MOHP), Monitoring Evaluation and Operational Research (MEOR) Nepal. Nepal Burden of Disease 2017; 2017.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner