ArticlePatient preference and adherence2019
A cultural adaptation and validation study of a self-report measure of the extent of and reasons for medication nonadherence among patients with diabetes in Singapore.
Article in Patient preference and adherence, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Measurement Properties of Existing Patient-Reported Outcome Measures on Medication Adherence: Systematic Review.Journal of medical Internet research · 2020Pooled it
- Development of an Item Bank to Measure Medication Adherence: Systematic Review.Journal of medical Internet research · 2020Pooled it
- Self-Reported Adherence to Cancer Therapy: Development and Validation of the Domains of Subjective Extent of Nonadherence-Cancer Measure.JCO oncology practice · 2026Article
- Recommendations for Designing a Digital Health Tool for Blindness Prevention Among High-Risk Diabetic Retinopathy Patients: Qualitative Focus Group Study of Adults With Diabetes.JMIR formative research · 2025Article
- Impact of community public health care on treatment effect, health cognition, and self-management in patients with type 2 diabetes.World journal of clinical cases · 2025Article
- Article
- Self-Care Management, Patient Education, and Nursing Support in Patients with Diabetes and Hypertension.Galen medical journal · 2024Review
- EMPOWERing Patients With Diabetes Using Profiling and Targeted Feedbacks Delivered Through Smartphone App and Wearable (EMPOWER): Protocol for a Randomized Controlled Trial on Effectiveness and Implementation.Frontiers in public health · 2022Article
- Validating a Self-Reported Medication Nonadherence Measure in the Context of Multiple Chronic Diseases and Routes of Medication Administration Among Patients with Type 2 Diabetes.Patient preference and adherence · 2022Article
- The eight-item Morisky Medication Adherence Scale: validation of its Persian version in diabetic adults.Caspian journal of internal medicine · 2021Article
- Cross-cultural adaptation, validity, and reliability of the Nepali version of the Exercise Adherence Rating Scale: a methodological study.Health and quality of life outcomes · 2020Article
- Translation, Cross-Cultural Adaptation, and Validation of the Kannada Version of the Exercise Adherence Rating Scale (EARS-Kn) Among Head and Neck Cancer (HNC) Survivors in a Tertiary Care Setup in India.Integrative cancer therapiesArticle
- Adherence to Medication in Children With Liver Disease in India, the First Report - Every Journey Starts With a First Step!Journal of clinical and experimental hepatologyArticle
Corrections and comments
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Authors and funding
19 authors at 8 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis self-report measure is a new instrument to measure the extent of and reasons for medication adherence separately. However, few studies have assessed its psychometric properties in diabetic patients and also in Asian populations.
objectivesTo validate this self-report measure in diabetic patients in Singapore.
methodsWe collected data prospectively using a questionnaire among 393 diabetic patients from hospitals in Singapore from July 2018 to January 2019. Using the COnsensus-based Standards for the selection of health Measurement INstruments framework, we assessed face validity, internal consistency, test-retest reliability, structural validity, and measurement error. We tested four a priori hypotheses on correlation of extent score with patient-reported outcome measures to assess construct validity. We examined cross-cultural validity via measurement invariance across gender, age groups, and languages.
resultsWe performed cognitive interviews with 30 consenting English-literate, Chinese-literate, and Malay-literate (10 patients per language) diabetic patients (age range 48-76 years, 53% male, disease duration range 1-30 years) and face validity was supported. Among 393 patients (mean age: 59.4±12.2 years, 50.9% female, 52.4% Chinese), we showed moderate internal consistency (Cronbach's alpha =0.67) and test-retest reliability (intra-class coefficient=0.56 [95% CI 0.37-0.70]). We calculated smallest detectable change as 0.80. We established construct validity by meeting all four hypotheses. We showed structural validity as confirmatory factor analysis confirmed a one-factor model, with excellent fit statistics (Comparative Fit Index=1.0; Tucker-Lewis Index=1.0; Root Mean Square Error of Approximation<0.001; Standardized Root Mean Residuals<0.001). Analysis of cross-cultural validity supported configural invariance model but not metric invariance and scalar invariance model. Caution must be taken against directly comparing extent scores across gender, age groups, and languages.
conclusionThis self-report measure is valid and reliable in measuring medication adherence in diabetic patients in Singapore.
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