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Reliability and validity of the Chinese version of the eight-item Morisky Medication Adherence Scale in Chinese patients with systemic lupus erythematosus

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Abstract

Objective

To evaluate the reliability and validity of the Chinese version of the eight-item Morisky Medication Adherence Scale (MMAS-8) in Chinese patients with systemic lupus erythematosus (SLE).

Methods

The survey was conducted with a consecutive sampling of 158 Chinese SLE patients attending public hospitals from January to March 2021. We used the translated Chinese version of the MMAS-8 to collect related data. Reliability, item, and factor analyses were used to test the reliability and validity of the MMAS-8 scale in the selected patients. The internal consistency reliability was evaluated using Cronbach’s α coefficient. Test–retest reliability was assessed using intraclass correlation coefficients (ICCs) in a subset of 30 participants. Construct validity was evaluated using confirmatory factor analysis and correlations between the Self-efficacy for Appropriate Medication Use Scale (SEAMS) and related measures.

Results

The internal consistency reliability of the Chinese version of the MMAS-8 was high (Cronbach’s α = 0.817), and the test–retest reliability was excellent (intraclass correlation = 0.947; P < 0.001). There were significant differences in the F test and t test between the two extreme groups before and after the ranking of 27% of the questionnaire scores (P < 0.001). The Kaiser–Meyer–Olkin (KMO) value of construct validity was 0.860. The spherical test value of Bartlettgers was 417.8822. Factor analysis yielded three components that accounted for 69.375% of the total variance. Exploratory factor analysis identified three dimensions of the Chinese version of the MMAS-8. In terms of criterion validity, the correlation of the MMAS-8 score in SEAMS indicated that the convergent validity was good (r = 0.926; P < 0.001).

Conclusions

This study shows that the Chinese version of the Medication Adherence Scale-8 is a reliable and valid tool for assessing medication adherence in Chinese SLE patients.

Key Points

• Many factors affect medication adherence in SLE patients.

• Many questionnaires measure medication adherence levels.

• There is a lack of reliable validation of medication adherence questionnaires specifically for SLE patients.

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Funding

This manuscript was supported by a project grant from the Anhui Provincial Natural Science Foundation (1908085MH294) and a grant from the Seedling cultivation programme of the School of Nursing, Anhui Medical University (hlqm2021008).

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Authors and Affiliations

  1. School of Nursing, Anhui Medical University, 15 Feicui Road, Hefei, 230032, Anhui, China

    Pei-Li Shi, Zhen-Zhen Wu, Li Wu, Rui-Chen Gao, Zhen-Gang Wu & Guo-Cui Wu

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  1. Pei-Li Shi
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  2. Zhen-Zhen Wu
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  3. Li Wu
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  4. Rui-Chen Gao
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  5. Zhen-Gang Wu
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  6. Guo-Cui Wu
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Contributions

P.L.S and G.C.W conceived the study. P.L. S, Z.Z.W, and G.C.W designed the study. P.L. S and L.W conducted the questionnaire investigation. P.L.S and G.C.W analysis analysed the data. P.L. S, R.C.G, and Z.G.W interpreted the data. P.L.S and G.C.W wrote the draft of the manuscript. G.C.W critically revised the manuscript. All authors approved the submission of the final version of the manuscript.

Corresponding author

Correspondence to Guo-Cui Wu.

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Pei-Li Shi and Zhen-Zhen Wu contributed equally to this work and should be considered co-first authors.

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Shi, PL., Wu, ZZ., Wu, L. et al. Reliability and validity of the Chinese version of the eight-item Morisky Medication Adherence Scale in Chinese patients with systemic lupus erythematosus. Clin Rheumatol 41, 2713–2720 (2022). https://doi.org/10.1007/s10067-022-06195-y

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