Self-report instruments for assessing medication adherence validated in Brazil: a scoping review
DOI:
https://doi.org/10.30968/jhphs.2025.161.1212Abstract
Objective: To identify validated self-report instruments measuring medication adherence in Brazil. Methodology: A systematic search was conducted in the databases PubMed/Medline, Scopus, Web of Science, EMBASE, and LILACS to identify validation studies of self-report adherence instruments conducted in Brazil until September 2023. The following health descriptors were used for study identification: “medication adherence,” “self-report,” “patient-reported outcome measures,” “validation study,” and “psychometrics.” Article selection was performed by two independent reviewers based on established eligibility criteria. The quality of the studies was assessed using the COSMIN checklist. Results: The initial search identified 329 studies, of which 9 were included in this review. Nine instruments were identified: BAASIS, CEAT-VIH, MAT, MMAS-8, ITAS, QAM-Q, PEDIA, SEA-ART, and WebAd-Q, which were validated for patients with chronic hypertension, transplant patients on immunosuppressants, patients with HIV undergoing antiretroviral treatment, and patients in general outpatient care. The PEDIA and SEA-ART scales showed the highest internal consistencies, while BAASIS and MMAS-8 demonstrated greater test-retest stability. Regarding construct validity, the SEA-ART and QAM-Q scales exhibited the highest combined sensitivity and specificity values. Conclusion: Although they offer advantages, few self-report instruments for measuring medication adherence have been validated in Brazilian patient samples. The heterogeneity of results regarding psychometric properties and validation tests focused on specific clinical conditions does not allow for broad recommendations for any instrument at this time; it is necessary to consider the type of patient and the advantages of each instrument for the chosen population. Additionally, several chronic health conditions still lack adequately validated instruments, such as diabetes mellitus, cardiovascular diseases like angina and heart failure, among others.
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