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J Int Med Res. 2013 Aug;41(4):1098-110. doi: 10.1177/0300060513484433. Epub 2013 Jul 16.

Reliability and validity of a self-reported measure of medication adherence in patients with type 2 diabetes mellitus in Korea.

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  • 1Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.



This study examined the psychometric properties of the Korean version of the eight-item Morisky Medication Adherence Scale (MMAS-8) to measure adherence to diabetes medication in patients with type 2 diabetes mellitus.


The English version of the MMAS-8 was translated into Korean and administered to patient with type 2 diabetes mellitus via face-to-face interviews, conducted by an independent interviewer. Patient characteristics and glycosylated haemoglobin (HbA1c) levels were assessed at the same clinic visit. A proportion of patients was randomly selected for 2-week test-retest reliability via telephone interviews. Convergent validity of the MMAS-8 against a four-item MMAS, correlations with HbA1c levels and construct validity of the MMAS-8 were evaluated.


In total, 317 patients were included; 70 completed the 2-week test-retest interview. Internal consistency reliability was moderate and test-retest reliability of the MMAS-8 was excellent, although a ceiling effect was detected. Good convergent validity was shown by the high correlation of the new scale scores with the original MMAS-4. A significant association was found between MMAS-8 scores and HbA1c levels. Using glycaemic control as a gold standard, sensitivity was 74.1% and specificity was 38.3%. Explanatory factor analysis identified three dimensions of the scale.


In light of acceptable reliability and validity, the MMAS-8 is a simple and quick method for the assessment of medication adherence among patient with type 2 diabetes mellitus, in a busy clinic setting.


Eight-item Morisky Medication Adherence Scale; MMAS-8; medication adherence; psychometrics; self-report questionnaire; type 2 diabetes mellitus

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