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Concordance of Pharmacist Assessment of Medication Nonadherence With a Self-Report Medication Adherence Scale

Michael S Kelly1, Leticia R Moczygemba2, Sharon S Gatewood3

  • 1School of Pharmacy, Virginia Commonwealth University, Richmond, VA, USA.

Journal of Pharmacy Practice
|October 15, 2014
PubMed
Abstract

Insights

The Modified Morisky Scale (MMS) showed poor concordance with pharmacist assessments of medication adherence in behavioral health patients. Combining self-report tools with pharmacist evaluations may offer better adherence insights.

Area of Science:

  • Pharmacology
  • Behavioral Health
  • Clinical Pharmacy

Background:

  • Medication adherence is crucial for treatment success, especially in behavioral health.
  • Accurate assessment of adherence is challenging.
  • The Modified Morisky Scale (MMS) is a self-report tool used to measure adherence.

Purpose of the Study:

  • To evaluate the concordance between the Modified Morisky Scale (MMS) and pharmacist assessments of medication adherence.
  • To compare the 6-item MMS and the original 4-item Morisky Scale against pharmacist evaluations.

Main Methods:

  • Retrospective analysis of electronic medical records (EMRs) from a homeless behavioral health clinic.
  • Included patients aged 18+ who underwent pharmacist medication reviews.
  • Used McNemar test to assess agreement between MMS (6-item and 4-item) and pharmacist adherence assessments.

Main Results:

  • Nonadherence rates were higher with the MMS (61.7% for 6-item, 49.7% for 4-item) compared to pharmacist assessment (23.8%).
  • Significant differences (P < .0001) were found between MMS scores and pharmacist assessments.
  • The study included 288 patients and 449 medication reviews.

Conclusions:

  • The Modified Morisky Scale (MMS) demonstrated low concordance with pharmacist adherence assessments.
  • Pharmacist evaluations identified lower rates of nonadherence than the MMS.
  • A combination of self-report and clinical assessment may be optimal for evaluating medication adherence.
Keywords:
medication adherencemedication therapy reviewpharmacistself-report scale

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