ArticleDiabetic medicine : a journal of the British Diabetic Association2025
A validation study of the Intentional Nonadherence Scale among people with type 2 diabetes in the United Kingdom.
Article in Diabetic medicine : a journal of the British Diabetic Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Understanding Medication Adherence and Glycaemic Level in People With Type 2 Diabetes Across Countries: A Cross-Sectional and Longitudinal Analysis of Medication Beliefs, Illness Perceptions, Resistance to Illness and Mood.Endocrinology, diabetes & metabolism · 2026Article
- A validation study of the Intentional Nonadherence Scale among people with type 2 diabetes in the United Kingdom.Diabetic medicine : a journal of the British Diabetic Association · 2025Article
- Beyond the Prescription: Association Between Illness Perception and Medication Adherence in Chronic Obstructive Pulmonary Disease Patients in Jordan.SAGE open nursingArticle
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Authors and funding
5 authors.
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Abstract
aimTo examine the psychometric properties of the Intentional Nonadherence Scale (INAS) among people with type 2 diabetes mellitus (PwT2D) in the United Kingdom.
methodsThis validation study recruited 260 PwT2D at diabetes intermediate care team clinics in London. Thirty of them participated in the test-retest reliability analysis in 2-4 weeks, while 124 were followed up in 3-6 months for the predictive validity analysis. The psychometric evaluation also comprised internal reliability, structural validity and construct validity that assessed the relationship between the INAS and other established measures, such as the Medication Adherence Report Scale-5 (MARS-5), Beliefs about Medicine Questionnaire (BMQ)-specific, Brief Illness Perception Questionnaire (BIPQ), Patient Health Questionnaire-2 (PHQ-2) and glycated haemoglobin (HbA1c).
resultsExploratory factor analysis revealed four factors, namely 'Resisting illness', 'Resisting medication', 'Testing treatment' and 'Sensitivity to medication'. All INAS factors demonstrated high internal reliability (Cronbach's alpha = 0.92-0.96). Their test-retest reliability varied between <0.001 and 0.92. Construct validity was demonstrated by its relationship with other measures, including its negative correlations with medication adherence and positive correlations with medication concerns. Significant correlations were also found with HbA1c, as well as with PwT2D's perceptions of diabetes consequences, treatment control, identity and emotional responses to diabetes. 'Testing Treatment' showed a trend towards statistical significance with adherence in 3-6 months (coefficient = -0.34, p = 0.09).
conclusionsThe INAS performed well on a number of psychometric properties in this study. It may be a helpful tool for clinicians in identifying specific drivers of intentional nonadherence among PwT2D.
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