Answer

Response 1

Hello Jeff, let me first acknowledge the importance of your discussion question in promoting the quality of patient outcome. Indeed, medication non-adherence is a major challenge that requires a comprehensive evaluation and the implementation of effective mitigation approaches. In chronic illnesses, as you have identified, they require strict adherence to the medication schedule. Failure to this adherence affects the rate of recovery of the individual (Vrijens et al., 2017). To contribute to your discussion, establishing the cause of non-adherence to medication should factor in the patient’s personal factors and other healthcare conditions. For patients with multiple chronic illnesses, polypharmacy may be a critical challenge affecting their medication adherence.

The MMAS 8 scale is indeed a reliable and valid instrument in examining medication non-adherence. Notably, the 5-point Likert scale reflects on a high level of measurement which promotes the instrument’s validity and reliability. To further contribute to your discussion, the MMAS-8 update is characterized by a higher sensitivity and is indeed the most used instrument to examine medication non-adherence. According to Wong et al. (2015), the closed dichotomous questions which require the respondent to either use yes or no is vital in preventing bias from the patients’ positive responses. Notably, the responses associated with the respondent’s adherence behavior are reversed. Every item in this scale examines a particular adherence behavior, and only the last question allows for using a scale (always, often, sometimes, almost never, and never). When using this instrument, the level of adherence is based on the total score of the correct responses. High adherence is described by eight points, average adherence (6 – <8), and poor adherence is described by (< 6 points).

References

Vrijens, B., Antoniou, S., Burnier, M., de la Sierra, A., & Volpe, M. (2017). Current situation of medication adherence in hypertension. Frontiers in pharmacology, 8, 100.

Wong, M. C., Wu, C. H., Wang, H. H., Li, H. W., Hui, E. M., Lam, A. T., … & Morisky, D. E. (2015). Association between the 8‐item Morisky medication adherence scale (MMAS‐8) score and glycaemic control among Chinese diabetes patients. The Journal of Clinical Pharmacology, 55(3), 279-287.

Response 2

Hello Paula, I concur with you on using the Likert scale to promote the study validity and reliability. The quantification of the perceptions, attitudes, and opinions into subjective data that can be numerically analyzed allows the researcher to establish the relationship between the study constituents or variables in the social world which is in line with the positivist philosophy in research. Besides the validity of the Likert scale being centered on the applicability of the survey to the topic, the interval and ratio scales are identified as high levels of measurements which also increases the study quality and reliability (Joshi, Kal, Chandel, & Pal, 2015).

To contribute to your discussion, establishing responses from various respondents including nurses and patients provide comprehensive data whose analysis may be used to improve one’s understanding of the topic. The 5-7 choices is also an essential approach in presenting the respondents with flexibility in choosing the most suitable response. To solve your challenge of selecting an instrument with the correct wording, I would suggest the consideration of adopting and adapting approaches to an instrument or developing your questions from literature and as guided by the research objectives. According to Aboshady et al. (2015), the adoption or adaption of a research instrument depends on the relationship between one’s study and others which have been done previously. However, there are situations where the research may not conform to the existing studies. At such a point, the individual has the option to develop an instrument although it must be guided by the research board and experts. Also, this approach is complex since validity and reliability issues have to be considered.

References

Aboshady, O. A., Radwan, A. E., Eltaweel, A. R., Azzam, A., Aboelnaga, A. A., Hashem, H. A., … & Noaman, A. M. (2015). Perception and use of massive open online courses among medical students in a developing country: multicentre cross-sectional study. BMJ open, 5(1), e006804.

Joshi, A., Kale, S., Chandel, S., & Pal, D. K. (2015). Likert scale: Explored and explained. British Journal of Applied Science & Technology, 7(4), 396.