Abstract:Objective To evaluate the reliability and validity of the Morisky medication adherence scale (MMAS-8) in investigating the compliance of inhaled DPIs in COPD patients, to analyze the influence of different factors on medication compliance, and to evaluate the effect of medication management services on medication compliance. Methods A total of 110 patients with COPD who were hospitalized in the Department of Respiratory Medicine in a hospital from May to October 2019 were selected for MMAS-8 score and reliability and validity analysis. Drug treatment management services were provided to patients, and MMAS-8 was used to evaluate patients’ medication compliance before and after drug treatment management services. Results Among the 101 patients, the compliance at the time of enrollment was (4.39±2.01) points. There were statistically significant differences in the compliance of different medical insurance, educational level, and inhalation device usage time (P < 0.05). There was a significant difference in the mean scores of the two extreme groups in the top 27% (25 patients) and the bottom 27% (25 patients) of the total scale score (P < 0.05), and the internal consistency coefficient was 0.657. The validity (KMO) value was 0.680, and the Bartlett’s sphericity test value was 119.900. Three common factors were extracted, explaining 60.203% of the total variance. Adherence factors were medical insurance type, educational level, and inhalation device usage time. The patients’ compliance after a year was (6.25±1.06) points after the medication management service. There were statistically significant differences in the total compliance scores, unintentional, and intentional scores before and after medication therapy management service (P < 0.05). Conclusion The MMAS-8 scale has good reliability and validity, and medication management services can help improve the compliance of patients with inhaled DPIs.
袁菱 杨青 蔡宁 童德银. MMAS-8评价COPD患者吸入DPI类药物依从性的信效度分析及应用[J]. 中国医药导报, 2022, 19(5): 60-63.
YUAN Ling YANG Qing CAI Ning TONG Deyin. Reliability and validity analysis and application of MMAS-8 in evaluating the compliance of inhaled DPIs in patients with COPD#br#. 中国医药导报, 2022, 19(5): 60-63.
[1] 史展,孙雪荣,田颖,等.心房颤动患者口服抗凝药物依从性的研究进展[J].心血管病学进展,2020,41(1):18-22.
[2] Wei L,Yang X,Li J,et al. Effect of pharmaceutical care on medication adherence and hospital admission in patients with chronic obstructive pulmonary disease (COPD):a randomized controlled study [J]. J Thorac Dis,2014,6(6):656-662.
[3] Farias R,Sedeno M,Beaucage D,et al. Innovating the treatment of COPD exacerbations:A phone interactive telesystem to increase COPD Action Plan adherence [J]. BMJ Open Respir Res,2019,6(1):e000379.
[4] Trindade AJ,Tinsley A,Kornbluth A,et al. The MMAS-8,a screening tool for determining nonadherent behavior,should not be dismissed in IBD [J]. Am J Gastroenterol,2012,107(6):951-952.
[5] 吴凡,赵金霞,王天晟,等.中文版MMAS-8测量类风湿关节炎患者用药依从性的信效度分析[J].中国药房,2018, 29(2):263-268.
[6] 张斯钰,白丽琼,谭红专,等.Morisky服药依从性量表在肺结核患者中的应用[J].中国防痨杂志,2010,32(9):55-58.
[7] 丁平俊,史会请,李斌.MMAS-8量表在高血压患者中的信效度评定[J].临床医药文献电子杂志,2017,4(39):7566-7567.
[8] 陈强,曲珊珊,黄欣.MMAS-8评价心血管慢病患者用药依从性的信效度分析与实践[J].中国药房,2019,30(2):129-132.
[9] 翁艳君.MMAS-8在T2DM患者中的信效度评价及应用研究[D].昆明:昆明医科大学,2017.
[10] 崔淑节,李湘萍,陈嘉兴,等.服药依从性量表评价门诊高血压患者服药依从性的信度与效度研究[J].护理管理杂志,2018,18(2):93-96,111.
[11] Yan J,You LM,Yang Q,et al. Translation and validation of a the 8-item Morisky medication adherence scale in myocardial infarction patients [J]. J Eva Clin Pract,2014, 20(4):311-317.
[12] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.慢性阻塞性肺疾病基层诊疗指南(2018年)[J].中华全科医师杂志,2018,17(11):856-870.
[13] Hu W,Hu S,Zhu Y,et al. Assessing Oral Medication Adherence and Identifying Predictors of Low Adherence in Chinese Inflammatory Bowel Disease Patients [J]. Patient Prefer Adherence,2020,14:1083-1092.
[14] 沈俊,吴秋惠,陈燕华,等.慢性阻塞性肺疾病患者用药依从性的影响因素分析[J].药物流行病学杂志,2019, 28(7):483-486.
[15] 丁平俊,史会请,李斌.社区高血压患者的服药依从性现况调查以及相关因素分析[J].临床医药文献电子杂志,2017(45):183-184.
[16] Jansen EM,Hei S,Dierick B,et al. Global burden of medication non-adherence in chronic obstructive pulmonary disease (COPD) and asthma:a narrative review of the clinical and economic case for smart inhalers [J]. J Thorac Dis,2021,13(6):3846-3864.
[17] López-Campos JL,Quintana Gallego E,Carrasco Hernández L. Status of and strategies for improving adherence to COPD treatment [J]. Int J Chron Obstruct Pulmon Dis,2019,14:1503-1515.
[18] Jia X,Zhou S,Luo D,et al. Effect of pharmacist-led interventions on medication adherence and inhalation technique in adult patients with asthma or COPD:A systematic review and and meta-analysis [J]. J Clin Pharm Ther,2020,45(5):904-917.
[19] 张利芳,姚星烂,胡晓波.基于问题导向的慢性病干预行为对老年COPD患者用药依从性及生活质量影响[J].中国医药导报,2020,17(31):122-125.
[20] Maricoto T,Monteiro L,Gama JMR,et al. Inhaler Technique Education and Exacerbation Risk in Older Adults with Asthma or Chronic Obstructive Pulmonary Disease:A Meta-Analysis [J]. J Am Geriatr Soc,2019,67(1):57-66.
[21] Jang JG,Kim JS,Chung JH,et al. Comprehensive Effects of Organized Education for Patients with Chronic Obstructive Pulmonary Disease [J]. Int J Chron Obstruct Pulmon Dis,2019,14:2603-2609.
[22] Ahn JH,Chung JH,Shin KC,et al. The effects of repeated inhaler device handling education in COPD patients:a prospective cohort study [J]. Sci Rep,2020,10(1):19676.
[23] Lengel M,Kuhn CH,Worley M,et al. Pharmacy technician involvement in community pharmacy medication therapy management [J]. J Am Pharm Assoc (2003),2018,58(2):179-185.
[24] 赵文敏,杨毅,田侃.美国药物治疗管理模式对我国基层医疗机构药学服务能力建设的启示[J].中国新药杂志,2019,28(11):16-20.
[25] Nduaguba S,Barner JC,Makhinova T,et al. Medication Therapy Management for Texas MediCAID Patients With Asthma and Chronic Obstructive Pulmonary Disease-A Pilot Study [J]. J Pharm Pract,2021:897190021997032.
[26] 林茂,陈哲,曾力楠,等.国内,外药物治疗管理文献研究现状分析[J].中国药房,2019,30(17):2305-2310.