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The Morisky Scales consist of two subscales, unintentional and intentional non-adherence, that are coded as four dichotomous (yes/no) variables in the MMAS-4 and seven dichotomous variables with a 5-point Likert scale in the MMAS-8.
Intentional medication non-adherence is an active decision from the patient to take their medication as prescribed. This is a process in which a patient makes a rational decision based on the benefits of medication adherence compared to risks of medication non-adherence. Unintentional medication non-adherence is a passive process in which the patient does not adhere to how the medication is prescribed because they forget, don’t understand, or because of poor health literacy.
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Many patients suffer from a chronic disease and remembering to take all their medication as prescribed can mean the difference between life and death. The MMAS-8 scale is a validated diagnostic tool that identifies when polypharmacy is a reason for medication non-adherence. Did you take all your medication when you were last supposed to? How often do you have difficulty taking all your medication as prescribed? The MMAS-8 questions number 5 and 8 provides health care providers the magnitude of polypharmacy non-adherence with an .83 internal consistency and 93% sensitivity. The Morisky Protocol assesses the differential impact of unintentional (forgetfulness and polypharmacy) and intentional (stopping use of medication if feeling better or worse) medication non-adherence.
Million Hearts® is a national initiative to prevent 1 million heart attacks and strokes within 5 years. Read more how the Morisky Scales are used.
Why is there a question about tobacco use on employee annual healthcare enrollment? Insurance carriers recognize that smokers have higher hospitalization rates.
It only makes sense to ask about medication adherence. Insurance carriers recognize highly adherent employee populations have lower hospital visits and hospital readmissions. The MMAS-4 or MMAS-8 is a validated tool insurance companies, insurance brokers and employers can use to lower employee health care cost. |
AuthorDr Donald Morisky. Archives
January 2025
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