Validation and psychometric properties of the 8-item Morisky Medication Adherence Scale (MMAS-8) in Type 2 diabetes patients in sub-Saharan Africa

Objectives: Research in the field of adherence to medications has not been explored in sub-Saharan Africa. The goal of this manuscript is to (1) validate the use of an adherence tool: a translated 8-item Morisky Medication Adherence Scale (MMAS-8) for Type 2 diabetes and (2) assess association between levels of adherence and psychometric properties. Methods: 154 Type 2 diabetic patients being chronically treated were surveyed from Togo-lese Diabetes Association using a demographic survey, 4-item Morisky Medication Adherence Scale (MMAS-4) and MMAS-8 from January to March 2012. Results: Internal reliability for the 8-item scale showed the Cronbach alpha being 0.47. The MMAS-8 and MMAS-4 showed a Pearson's correlation of 0.6851. For known groups validity, the chi-square (chi(2)) tests of proportions showed a significant relationship between blood glucose control and MMAS-8 (chi(2) = 12.17; p = 0.002). The sensitivity, specificity, positive predictive value and negative predictive value were 75%, 48.39%, 56.76%, and 68.18% respectively. Conclusions: Psychometric analyses showed that the MMAS-8 was a suitable way of measuring medication adherence in the study population given its low cost, ease of use, and the low income status of the country. (C) 2015 Elsevier Ireland Ltd. All rights reserved.