[Validation of multidimensional adherence questionnaire for liver transplantated patients (MAQ)]

Nonadherence is considered as determinant for the increase of morbility and mortality, reduction of quality of life, increase of medical costs and excess health services utilization in transplanted patients, and it can be direct cause of 21% of the fails of transplants and 26% of the mortality after transplantation. It was demonstrated that patient description obtained by means of an interview with a good questionnaire is the best way to access to adherence. In transplanted patients, non adherence with a more extended sense, is much more prevalent than adherence related only with medication intake, and therefore the instrument that should be used to measure adherence in this population should be a questionnaire that accesses adherence in a more extended sense. There wasn't found in literature any instrument to evaluate multidimensional adherence in liver transplanted patients. Based on an extended review of literature and with supervision of hepatologists the authors elaborated a questionnaire that mentions 3 adherence dimensions: presence in medical appointments and exams, medication intake and alcohol ingestion, with three questions to each dimension. This questionnaire has passed threw several steps to be validated: cognitive debriefing, liability tests, concept validity, construct validity, and criterium validity.