INTRODUCTIONThe aim of this study was to assess the reliability and validity of a modified Malaysian version of the Medication Adherence Reasons Scale (MAR-Scale).

METHODSIn this cross-sectional study, the 15-item MAR-Scale was administered to 665 patients with hypertension who attended one of the four government primary healthcare clinics in the Hulu Langat and Klang districts of Selangor, Malaysia, between early December 2012 and end-March 2013. The construct validity was examined in two phases. Phase I consisted of translation of the MAR-Scale from English to Malay, a content validity check by an expert panel, a face validity check via a small preliminary test among patients with hypertension, and exploratory factor analysis (EFA). Phase II involved internal consistency reliability calculations and confirmatory factor analysis (CFA).

RESULTSEFA verified five existing factors that were previously identified (i.e. issues with medication management, multiple medications, belief in medication, medication availability, and the patient's forgetfulness and convenience), while CFA extracted four factors (medication availability issues were not extracted). The final modified MAR-Scale model, which had 11 items and a four-factor structure, provided good evidence of convergent and discriminant validities. Cronbach's alpha coefficient was > 0.7, indicating good internal consistency of the items in the construct. The results suggest that the modified MAR-Scale has good internal consistencies and construct validity.

CONCLUSIONThe validated modified MAR-Scale (Malaysian version) was found to be suitable for use among patients with hypertension receiving treatment in primary healthcare settings. However, the comprehensive measurement of other factors that can also lead to non-adherence requires further exploration.

Adult ; Antihypertensive Agents ; therapeutic use ; Cross-Sectional Studies ; Factor Analysis, Statistical ; Female ; Humans ; Hypertension ; complications ; Malaysia ; Male ; Medication Adherence ; Middle Aged ; Primary Health Care ; methods ; Psychometrics ; methods ; Reproducibility of Results ; Self Report ; Surveys and Questionnaires

Introduction: The Asthma Knowledge Questionnaire developed by C. Rodriguez Martinez in 2005 was proved to be a valid instrument for asthma knowledge assessment for parents of children with asthma. 17 items were included in the questionnaire including their myths and beliefs, knowledge, and associated aspects. The objective of this study is to analyse the validity and reliability of the Malay version of the questionnaire. Methods: Forward-Backward translation method was used by language experts to obtain the Malay version of the questionnaire. The questionnaire was then given to twenty respondents at the Paediatric Institute Hospital Kuala Lumpur to ensure the clarity and relevance of the questionnaire as a pilot study. Subsequently, 60 respondents who fulfilled the inclusion and exclusion criteria were selected to proceed with the reliability test of the Malay version questionnaire. The results were analysed with SPSS version 26.0. The reliability and internal consistency were confirmed by intra-class correlation and Cronbach’s alpha coefficient. Results: There were 60 respondents to the questionnaire consisting of parents and caretaker who has child with asthma at the Institute of Paediatric Hospital Kuala Lumpur. The mean age of respondents was 34 ± 7.5year old. 91.7% of the respondents were female. The overall Cronbach’s alpha coefficient of the questionnaire was 0.84. Conclusion: The Malay version of the Asthma Knowledge Questionnaire has a good degree of validity, reliability and is culturally acceptable equivalent to the original version.