Translation and validation of the English version of the general medication adherence scale (GMAS) in patients with chronic illnesses

Figures & data

Table 1. Scale construct and items.

Constructs	Items
1. Non-adherence due to patient’s behavior, i.e. un-intentional and intentional non-adherence	1. Do you have difficulty in remembering to take your medications?
	2. Do you forget to take your medication due to your busy schedule, traveling, meeting, events at home, party, marriage, religious celebrations, etc.?
	3. Do you discontinue your medication when you feel well?
	4. Do you stop taking medications when you feel adverse effects such as gastric discomfort, etc.?
	5. Do you stop taking medications without informing the doctor?
2. Non-adherence due to additional disease and pill burden	6. Do you discontinue your medicines due to other medicines that you have to take for your additional disease?
	7. Do you find it is a hassle to remember your medications due to medication regime complexity?
	8. During the last month, had there been any occasion when you missed your medicines due to progression of disease and addition of new medicines?
	9. Do you alter medication regimen, dose, and frequency by yourself?
3. Cost-related non-adherence	10. Do you discontinue these medications because they are not worth the money you spent on them?
	11. Do you find it difficult to buy your medicines because they are expensive?

Table 2. Patients’ demographic information.

Demographic information	Sample (n)	Percentage
Gender
Male	93	47.4
Female	103	52.6
Marital status
Married	133	67.9
Single	63	32.1
Educational status
Primary (up to 6 years of education)	4	2
Secondary (up to 10 years)	10	5.1
Higher secondary (up to 12 years)	33	16.8
Graduate (up to 16 years of education)	130	66.3
Post-graduate (>16 years of education)	19	9.7
Occupation
Employed	58	29.6
Un-employed	35	17.9
Retired	32	16.3
Household	51	26
Self employed	20	10.2
Residence
Urban	183	93.4
Rural	13	6.6
Health insurance coverage
Insurance coverage	66	33.7
No insurance coverage	130	66.3
Comorbidity
Yes	122	62.2
No	74	37.8
Type of illness
Hypertension	41	20.9
Diabetes mellitus type I and II	24	12.2
Chronic kidney disease	9	4.6
Chronic obstructive pulmonary disorder	18	9.2
Rheumatoid arthritis	9	4.6
Osteoarthritis	7	3.6
Ischemic heart disease	12	6.1
Dyslipidemia	2	1
Depression	8	4.1
Asthma	5	2.6
Thyroid disorders (hyperthyroidism, hypothyroidism, etc.)	5	2.6
Liver diseases (jaundice, hepatitis A, B and C, cholithiasis, etc.)	16	8.2
Inflammatory bowel disease (Crohn’s disease, ulcerative colitis, etc.)	5	2.6
Psychiatric disorders (Parkinsonism, Alzheimer’s disease, epilepsy, etc.)	21	10.7
Gout	3	1.5
Metabolic disorders (Obesity, malnutrition, etc.)	11	5.6

Table 3. Factor structure.

	Components
Constructs	1	2	3
1	0.503
	0.708
	0.727
	0.770
	0.738
2		0.541
		0.773
		0.783
		0.836
3			0.903
			0.618