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Psychometric Evaluation of Chinese Version of Adherence to Refills and Medications Scale (ARMS) and Blood-Pressure Control Among Elderly with Hypertension

Authors Chen YJ, Chang J, Yang SY

Received 27 October 2019

Accepted for publication 25 December 2019

Published 10 February 2020 Volume 2020:14 Pages 213—220

DOI https://doi.org/10.2147/PPA.S236268

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Naifeng Liu


Yi-Jing Chen,1,2 Jing Chang,1 Si-Yu Yang3

1Department of Health Care Clinic, First Affiliated Hospital of Zhengzhou University, Henan, People’s Republic of China; 2Academy of Medical Science, Zhengzhou University, Henan, People’s Republic of China; 3Xiangya Medical School, Central South University, Changsha, People’s Republic of China

Correspondence: Jing Chang Email jingchang101@163.com

Objective: This study aimed to develop the ARMS-C and test its psychometric properties in hypertensive patients, to assess the level of medication adherence and to identify associated predictors for medication adherence and blood-pressure control among Chinese hypertensive patients.
Methods: Hypertensive elderly who met inclusion criteria were recruited from an aged-care facility in Henan Province between January 2019 and July 2019. The patients completed the adapted ARMS-C. The scale’s factor structure, internal consistency, and construct validity were tested.
Results: Good internal consistency (Cronbach’s α=0.89) and test–retest reliability (r=0.86, p< 0.01) were obtained. Item-total correlation coefficients for the ten-item ARMS-C were 0.505– 0.801. Factor analysis of construct validity identified two factors, explaining a total variance of 63.3%. Binary regression showed that patients with scores at level 2 (≤ 20 ARMS-10 scores < 30) were six times as likely to have blood pressure uncontrolled as those at level 1 (ARMS-10 scores < 20, OR 6.6, 95% CI 1.7– 25.1; p=0.006), and patients with scores at level 3 (ARMS-10 scores > 30) were 115 times as likely to have blood pressure uncontrolled as those at level 1 (ARMS-10 scores < 20,OR 115, 95% CI 9– 1,470; p=0).
Conclusion: The ten-item ARMS-C is a reliable and valid self-reporting screening tool for adherence to medication and refills in elderly hypertensive Chinese patients.

Keywords: adherence, 10-item ARMS, hypertension, blood-pressure control

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