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Developing a scoring tool for assessing adherence to morbidity management and disability prevention (MMDP) practices
Ganga Ramar1, Anbusivam Sadhasivam1, Vijayalakshmi Gnanasekaran1
1Unit of Clinical and Molecular Medicine, ICMR-National Institute for Vector Control Research (NIVCR), Indira Nagar, Puducherry, India.
Background:
Morbidity Management and Disability Prevention (MMDP) practices are essential in mitigating the progression of lymphedema and in preventing episodes of adenolymphangitis. Despite their importance, patients' adherence to these prescribed practices has frequently been found to be suboptimal. Currently, there is a lack of a standardized tool for the objective assessment of patients' adherence to MMDP practices in patients with filarial lymphedema. This study was undertaken to develop a scoring system for assessing patients' adherence to MMDP and to validate this among patients attending a filariasis management clinic.
Methodology:
A scoring tool (VCRC MMDP Adherence Assessment Tool and VAAT score) was developed to evaluate adherence to MMDP practices across eight defined domains. The total score ranges from 0 to 40, reflecting the degree of adherence. This tool was validated through a cross-sectional study involving 90 patients diagnosed with varying grades of filarial lymphedema.
Results:
Based on the VAAT score, patients were categorizable into three different levels of adherence: optimal adherence (≥ 30), medium adherence (20-29) and poor adherence (< 20). Among the 90 patients assessed, 21 (23%) demonstrated optimal adherence, 47 (52%) showed medium adherence and 22 (25%) were categorized as having poor adherence.
Conclusion:
This study marks the first development and validation of a scoring system to assess adherence to MMDP practices in patients with filarial lymphedema. The tool proved useful in effectively identifying individuals with suboptimal adherence. However, further validation is required in a greater number of patients in a prospective manner and in different geographical and epidemiological settings.
