https://orcid.org/0000-0003-1822-3969
Abstract
Background
The General Medication Adherence Scale (GMAS) evaluates intentional and unintentional behaviour of patients, disease and medication burden and cost-related burden associated with non-adherence. GMAS was developed and validated among Urdu-speaking patients with chronic diseases. However, validated tool in Nepalese language to measure medication adherence among chronic illness patients currently does not exist.
Aim
To translate, culturally adapt, and validate the English version of GMAS into the Nepalese language to measure medication adherence among chronic illness patients.
Methods
The study was conducted among patients with chronic diseases in both hospital and community pharmacies of Nepal. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Good Practice Guideline for linguistic translation and cultural adaptation was used to translate and culturally adapt the English version of GMAS into the Nepalese version. The translated version was validated amongst patients with chronic diseases in Nepal. Exploratory factor analysis was carried out using principal component analysis with varimax rotation. Test–retest reliability and internal consistency were analysed.
Results
A total of 220 (53.6% females, and 51.4% of 51 to 70 aged patients) patients with chronic diseases participated in the study. The majority of patients took two medications (27.3%) from six months to five and half years (68.2%). Kaiser Meyer Olkin was found to be 0.83. A principal axis factor analysis was conducted on the 3 items of GMAS without and with orthogonal rotation (varimax). The scree plot showed an inflexion on the third item that meant three components were present. The overall Cronbach’s alpha value of the full-phase study was 0.82.
Conclusion
The General Medication Adherence Scale was successfully translated into the Nepalese language, culturally adapted, and validated amongst chronic diseases patients of Nepal. Therefore, the GMAS-Nepalese version can be used to evaluate medication adherence among Nepalese-speaking patients with chronic disease.
Data Sharing Statement
The datasets generated and analysed during the current study are available from the corresponding author on reasonable request. GMAS-Nepalese tool can be obtained contacting corresponding authors.
Ethical Approval and Consent to Participate
The study was conducted in accordance with the guidelines of declaration of Helsinki. The ethical approval was obtained from the Institutional Review Committee (IRC), Nobel College, Sinamangal, Kathmandu, Province Bagmati, Nepal. Written and verbal informed consent of the participants were taken before collecting their responses.
Acknowledgments
The authors are thankful to Dr Atta Abbas Naqvi for the permission to translate and validate GMAS into the Nepalese version. Also, thanks to all participants, patients and pharmacies involved in this study.
Author Contributions
All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval for the version to be published, and agreed to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no competing interests in this work.