Mapping Algorithm for the Morisky Scale and the five domains of medication non-adherence

The Morisky Medication Adherence Scale is a widely used tool to assess medication adherence. It consists of eight questions, each reflecting different domains of medication non-adherence.  Some factors can have an influence on both intentional and unintentional medication non-adherence.  Here's a mapping algorithm that relates each question to the five domains of medication non-adherence:

1. Domain: Patient-related
   • Question 1: Do you sometimes forget to take your medication(s)?
   • Question 4: When you travel or leave home, do you sometimes forget to bring along your medication(s)?
2. Domain: Socio-Economic-Related
   • Question 2: People sometimes miss taking their medications for reasons other than forgetting. Thinking over the past 2 weeks, were there any days when you did not take your medication(s)?
   • Question 5: Did you take your medication(s) yesterday?
3. Domain: Therapy-Related
   • Question 3: Have you ever cut back or stopped taking your medication(s) without telling your doctor, because you felt worse when you took it?
   • Question 8: How often do you have difficulty remembering to take all your medication(s)? Never/Rarely, Once in a while, Sometimes, Usually, All the time
4. Domain: Condition-Related
   • Question 6: When you feel like your health condition is under control, do you sometimes stop taking your medication(s)?
5. Domain: Healthcare-Related
   • Question 7: Taking medication(s) every day is a real inconvenience for some people. Do you ever feel hassled about sticking to your treatment plan?

It's important to note that this mapping algorithm is a generalized interpretation and may not capture every aspect of the domains of medication non-adherence perfectly. Some of the Morisky scale questions may overlap into other domains.  Question 5 deals with polypharmacy that may be related to multiple domains.  Additionally, the interpretation of the questions and their mapping to domains may vary slightly based on the context and specific research or clinical guidelines.