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Psychometric properties of the Polish version of the eight-item Morisky Medication Adherence Scale in hypertensive adults

Authors Jankowska-Polanska B, Uchmanowicz I, Chudiak A, Dudek K, Morisky DE, Szymanska-Chabowska A

Received 5 December 2015

Accepted for publication 9 March 2016

Published 9 September 2016 Volume 2016:10 Pages 1759—1766

DOI https://doi.org/10.2147/PPA.S101904

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Beata Jankowska-Polanska,1 Izabella Uchmanowicz,1 Anna Chudiak,1 Krzysztof Dudek,2 Donald E Morisky,3 Anna Szymanska-Chabowska4

1Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland; 2Department of Logistic and Transport Systems, Faculty of Mechanical Engineering, Wroclaw University of Technology, Wroclaw, Poland; 3Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA; 4Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Wroclaw, Poland


Abstract: Low adherence to pharmacological treatment is often associated with poor blood pressure control, but identification of nonadherent patients in outpatient settings is difficult. The aim of the study was to translate and evaluate the psychometric properties of the Polish version of the structured self-report eight-item Morisky Medication Adherence Scale (MMAS-8) among patients with hypertension. The study was conducted in a family doctor practice between January and July 2015. After a standard “forward–backward” procedure to translate MMAS-8 into Polish, the questionnaire was administered to 160 patients with hypertension. Reliability was tested using a measure of internal consistency (Cronbach’s α) and test–retest reliability. Validity was confirmed using known group validity. Three levels of adherence were considered based on the following scores: 0 to <6 (low); 6 to <8 (medium); and 8 (high). Complete questionnaires were returned by 110 respondents (mean age: 60.7 years ±12.6; 54.6% were female). The mean number of pills taken daily was 3.61±4.31. The mean adherence score was 6.42± 2.0. Moderate internal consistency was found (Cronbach’s α=0.81), and test–retest reliability was satisfactory (r=0.461–0.905; P<0.001). Reproducibility expressed by Cohen’s κ coefficient =0.61 was good. In high-adherent patients, the percentage of well-controlled blood pressure was higher than in low-adherent patients (33.3% vs 19.1%, χ2=0.87, P=0.648). Psychometric evaluation of the Polish version of the MMAS-8 indicates that it is a reliable and valid measure tool to detect nonadherent patients. The MMAS-8 may be routinely used to support communication about the medication-taking behavior in hypertensive patients.

Keywords: Morisky scale, medication adherence, hypertension, validation, pharmacological treatment

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