Academic Journal Articles Using MMAS-8 for Intentional and Unintentional Adherence

1. Article Title: Psychometric Properties of the Eight-Item Morisky Medication Adherence Scale (MMAS-8) in a Psychiatric Outpatient Setting
• Source: International Journal of Clinical and Health Psychology (ScienceDirect, PMC)
• Publication Date: December 24, 2014
• Details: This study examined the psychometric properties of the Spanish version of the MMAS-8 in 967 psychiatric outpatients. The scale was found to have adequate construct validity, with a one-factor solution, and it distinguished between intentional (e.g., not taking medication due to side effects) and unintentional (e.g., forgetfulness) non-adherence behaviors. It showed significant correlations with other scales like the Drug Attitude Inventory and was able to differentiate adherence levels across mental disorder diagnoses.
• Key Finding: The MMAS-8 effectively identifies intentional and unintentional non-adherence in psychiatric populations, facilitating targeted interventions.
2. Article Title: A Pilot Study to Identify Correlates of Intentional Versus Unintentional Nonadherence to Analgesic Treatment for Cancer Pain
• Source: Oncology Nursing Forum (PubMed)
• Publication Date: January 4, 2021
• Details: This study used the MMAS-8 to assess intentional (e.g., stopping medication when feeling better or worse) and unintentional (e.g., forgetfulness or carelessness) non-adherence to analgesics in cancer patients. Conducted with patients from outpatient oncology clinics, it found that 51% of participants took up to 60% of prescribed analgesic doses, with the MMAS-8 helping to isolate correlates of intentional versus unintentional non-adherence.
• Key Finding: The MMAS-8 was instrumental in distinguishing intentional from unintentional non-adherence, aiding in understanding barriers to analgesic adherence in cancer pain management.
3. Article Title: Revisiting the Internal Consistency and Factorial Validity of the 8-Item Morisky Medication Adherence Scale
• Source: SAGE Open Medicine (NCBI)
• Publication Date: October 18, 2016
• Details: This study analyzed the factorial validity of the French MMAS-8 in patients with type 2 diabetes. Factor analysis revealed two sub-scales: one for intentional non-adherence (e.g., stopping medication due to beliefs or side effects) and one for unintentional non-adherence (e.g., forgetfulness). The study suggested using sub-scale scores to separately assess these behaviors for targeted interventions.
• Key Finding: The MMAS-8 comprises two factors, allowing separate measurement of intentional and unintentional non-adherence, particularly in diabetes treatment.
4. Article Title: Reliability and Validity of a Modified 8-Item Morisky Medication Adherence Scale in Patients with Chronic Pain
• Source: Annals of Palliative Medicine
• Publication Date: August 10, 2021
• Details: This study evaluated a modified MMAS-8 in patients with chronic pain in China. Factor analysis identified two dimensions—intentional and unintentional non-adherence—explaining 62.978% of the variance. The study noted that items related to intentional (e.g., altering doses) and unintentional (e.g., forgetting) behaviors were distinct, though some items had low factor loadings due to cultural differences.
• Key Finding: The modified MMAS-8 can reflect intentional and unintentional non-adherence in chronic pain patients, though cultural adaptations may be needed.
5. Article Title: Self-Assessment of Adherence to Medication: A Case Study in Campania Region Community-Dwelling Population
• Source: Journal of Environmental and Public Health (PMC)
• Publication Date: 2015
• Details: This study used the Italian version of the MMAS-8 to assess adherence in a general population during a health promotion event. It found that 60.9% of non-adherent participants exhibited intentional non-adherence (e.g., stopping medication without consulting a doctor), while 13.4% showed unintentional non-adherence (e.g., forgetfulness). The study highlighted the role of education and smoking habits in adherence.
• Key Finding: The MMAS-8 identified intentional and unintentional non-adherence behaviors, linking intentional non-adherence to misconceptions about chronic conditions.