MARS-5 vs. MARS-10: Optimizing pharmacist-led adherence assessment in clinical heart failure practice

Area of Science:

• Cardiology
• Clinical Pharmacy
• Health Psychology

Background:

• Medication adherence is vital for effective heart failure (HF) management.
• Nonadherence is prevalent, especially in hospitalized and advanced HF patients.
• Accurate assessment tools are needed for clinical pharmacist interventions.

Purpose of the Study:

• To evaluate the reliability and score association of MARS-5 and MARS-10 in hospitalized HF patients.
• To assess the clinical relevance of these tools in real-world HF management.
• To determine the utility of MARS-5 as a practical tool for acute care settings.

Main Methods:

• Administered MARS-5 and MARS-10 self-report questionnaires during pharmacist-led interviews.
• Analyzed internal consistency reliability and score association between the two scales.
• Presented four clinical cases to illustrate adherence assessment in practice.

Main Results:

• Strong association found between MARS-5 and MARS-10 responses (Cohen's kappa = 0.820, Pearson's r = 0.899).
• MARS-5 reliably identified nonadherence (score < 20), comparable to MARS-10 (score ≤ 8).
• Nonadherent patients experienced serious complications (41.43% by MARS-5, 35.71% by MARS-10).

Conclusions:

• MARS-5 and MARS-10 are reliable and associated tools for assessing medication adherence in hospitalized HF patients.
• MARS-5 is a practical, time-efficient option for routine adherence assessment in acute settings.
• Clinical pharmacists play a critical role in identifying nonadherence and enabling interventions to improve HF outcomes.