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Developing the Diagnostic Adherence to Medication Scale (the DAMS) for use in clinical practice
Sara Garfield1, Lina Eliasson, Sarah Clifford
1The Centre for Medication Safety and Service Quality, UCL School of pharmacy, Mezzanine Floor, BMA House, Tavistock Square, London, UK. s.garfield@ucl.ac.uk
BMC Health Services Research
|October 9, 2012
Summary
The new Drug Adherence Monitoring Scale (DAMS) effectively monitors patient medication adherence in clinical practice. This validated tool is acceptable to patients and distinguishes adherence levels, though
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Health Services Research
Background:
- Existing adherence measures lack the ability to differentiate non-adherence types or track changes over time.
- A comprehensive adherence measure is needed for diverse patient populations, including those with multiple conditions and those using both patient and carer reports.
- A systematic review identified no existing measure meeting these criteria, necessitating the development of a new tool.
Purpose of the Study:
- To develop a theory-based adherence scale, the Drug Adherence Monitoring Scale (DAMS).
- To establish the content, face, and preliminary construct validity of the DAMS in a primary care setting.
- To create a tool suitable for routine clinical monitoring of medication adherence.
Main Methods:
- The DAMS, a 6-question scale, was developed from theory by a multidisciplinary team.
- Patients attending general practices were interviewed using the DAMS, Morisky-8, and Lu questionnaires.
- Spearman rank correlation and qualitative data explored the DAMS's validity and acceptability.
Main Results:
- 100 patients completed the DAMS quickly and found it easy to use.
- The DAMS demonstrated significant associations with other adherence measures (Spearman Rho 0.348-0.719, p < 0.01).
- Qualitative data helped explain discrepancies in adherence trends.
Conclusions:
- The DAMS is a valid and acceptable tool for routine monitoring of medication adherence in clinical practice.
- The scale is suitable for patients on single or multiple medications, but 'when required' medications require exclusion.
- Further validation against objective measures and reliability testing, including a carer version, are ongoing.
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