Development and validation of the Adherence to Asthma Medication
Questionnaire (AAMQ)
Abstract
Background: Adherence to medication is the cornerstone to
achieve the best treatment outcome. Pharmacists are healthcare
professionals found in pivotal positions to assess asthmatic patient’s
adherence to medication. A brief, reliable, and valid measure of patient
adherence is useful to enable the pharmacists to deliver that vital
service. This study aims to develop a reliable and valid adherence
assessment tool for asthmatic patients. Methods: The Adherence
to Asthma Medication Questionnaire (AAMQ-13) was developed based on an
extensive literature review, followed by applying the Delphi technique,
and then it was pilot-tested by 55 patients. The final AAMQ-13 was
completed by 213 patients. Psychometric evaluation was assessed
including reliability, criterion validity, and construct validity.
Results: The AAMQ-13 is a feasible 13 item questionnaire, as it
can be completed within an average of two minutes. It has high internal
validity (Cronbach’s alpha= 0.87). Criterion-concurrent validity was
established by comparing the AAMQ-13 to the Test of the Adherence to
Inhaler (TAI) and the pharmacy refill records. Criterion-convergent
validity was established by comparing the AAMQ-13 to the Asthma Control
Test (ACT) questionnaire and the Positive Health Behaviors Scale (PHBS).
Construct validity was established through AAMQ-13 factor analysis which
revealed two factors explaining 51.76% of the variance.
Conclusion: The AAMQ-13 is a reliable and valid questionnaire
with several desirable characteristics as it has a high internal
validity, good criterion validity, and strong construct validity. The
AAMQ-13 is a suitable questionnaire that can identify non-adherent
patients and reveal the reasons behind their non-adherence (intentional
or unintentional non-adherence).