Translation and validation of the Sindhi version of the general medication adherence scale in patients with chronic diseases

Md Ashraful Islam; Wajiha Iffat; Shahlla Imam; Sadia Shakeel; Abdul Rasheed; Atta Abbas Naqvi

doi:10.3389/fphar.2023.1235032

Translation and validation of the Sindhi version of the general medication adherence scale in patients with chronic diseases

Front Pharmacol. 2023 Sep 20:14:1235032. doi: 10.3389/fphar.2023.1235032. eCollection 2023.

Authors

Md Ashraful Islam¹, Wajiha Iffat², Shahlla Imam³, Sadia Shakeel⁴, Abdul Rasheed⁵, Atta Abbas Naqvi⁶

Affiliations

¹ Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
² Department of Pharmaceutics, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan.
³ Department of Pharmacognosy Institute of Pharmaceutical Sciences Jinnah Sindh Medical University Karachi, Karachi, Pakistan.
⁴ Department of Pharmacy Practice, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan.
⁵ Institute of Pharmaceutical Sciences, Jinnah Sindh Medical University Karachi, Karachi, Pakistan.
⁶ Reading School of Pharmacy, University of Reading, Whiteknights Campus, Reading, United Kingdom.

Abstract

Background: There is no medication adherence scale available in Sindhi language currently. Hence, the Sindhi speaking population will either use a translator or provide their medical history in another language for documentation of medical conditions. This poses a challenge in monitoring and evaluating adherence to medications within this linguistic community. Aim: The aim of this study was to translate and validate the Sindhi version of the General Medication Adherence Scale (GMAS-S) in patients with chronic diseases. Methods: This was a cross-sectional study of 4 months duration and was conducted in out-patient department of a university affiliated hospital in Karachi, Pakistan. All adults with chronic diseases, who were on long-term medications, and able to read and understand Sindhi language were invited. Convenience sampling was employed and a questionnaire consisting of demographic questions and the Sindhi version of GMAS was used. The translation of the scale was carried out. Confirmatory factor analysis (CFA) was conducted, and a structural equation model (SEM) was developed. Fit indices, namely, goodness of fit index (GFI), adjusted goodness of fit index (AGFI), Tucker Lewis index (TLI), comparative fit index (CFI), and root mean square error of approximation (RMSEA) were reported. Reliability was assessed using Cronbach's alpha (α), intraclass correlation coefficient (ICC), corrected item-to-total correlation (ITC) and item deletion. Data were analysed through IBM SPSS version 23 and IBM AMOS version 25. The study obtained ethical clearance. Results: A total of 150 responses were analysed. The reliability of the Sindhi version of GMAS was (α) = 0.696. The intraclass correlation coefficient (ICC) was reported at 0.696 (95% CI: 0.618-0.763). The values for the fit indices were as follows: χ²/df = 1.84, GFI = 0.918, TLI = 0.920, CFI = 0.942, AGFI = 0.864, and RMSEA = 0.075. All values except AGFI were in the acceptable ranges and indicated good fitness. Most participants (80.7%) appeared non-adherent to their medications. Conclusion: The results of the study demonstrate that the Sindhi version of the GMAS is a valid and reliable scale to measure adherence in Sindhi speaking persons with chronic diseases.

Keywords: Pakistan; Sindhi; medication adherence; patient preferences; questionnaire; validation studies.