Understanding Medication Adherence in Clinical Trials: The Role of Moriskyscale MMAS4 and MMAS8

The Moriskyscale MMAS4 and MMAS8, or Morisky Medication Adherence Scales, are a trusted and validated tool pharmaceutical companies, such as Jannsen, Abbvie, Opis, Merk, Pfizer, etc. use for developing and testing new medications. A critical aspect of ensuring the success of these medications is understanding patient adherence to prescribed regimens during clinical trials.

The Moriskyscale MMAS4 and MMAS8:
The Moriskyscale, developed by Dr. Donald E. Morisky is a validated tool designed to assess medication adherence. It is particularly relevant in clinical trials, where adherence is crucial for accurate evaluation of a medication's safety and efficacy. The MMAS4 and MMAS8 are two variations of the scale, each serving specific purposes.

Assessing Medication Adherence
- The MMAS4: This abbreviated version includes four simple questions that provide a quick assessment of adherence. It measures both intentional and unintentional non-adherence.
- The MMAS8: A more comprehensive version, it consists of eight questions that delve deeper into the domains and dimensions of medication non-adherence.

Domains and Dimensions of Medication Non-Adherence:

Intentional Non-Adherence This domain deals with patients deliberately choosing not to follow their medication regimens for various reasons. It can be attributed to personal beliefs, fears of side effects, or a desire to stop medication once symptoms improve.

Unintentional Non-Adherence Unintentional non-adherence encompasses patients missing doses or not adhering to their regimens due to external factors such as forgetfulness, lack of understanding, or complicated dosing instructions.

5 Dimensions of Medication Non-Adherence:

Healthcare-Related Factors Patients may be non-adherent because of a lack of communication with healthcare providers or insufficient support and education regarding their medications.

Socioeconomic-Related Factors Economic constraints, limited access to healthcare, or transportation issues can impact a patient's ability to adhere to their medication plan.

Patient-Related Factors Personal beliefs, attitudes, and mental health can significantly influence medication adherence. Understanding patient perspectives is crucial in addressing these issues.

Medication-Related Factors The complexity of medication regimens, side effects, and perceived effectiveness can all affect adherence. Some patients may discontinue medication if they experience undesirable side effects or lack perceived benefits.

Therapy-Related Factors The patient's overall experience with the therapy, including its convenience, efficacy, and any difficulties encountered, can determine whether they adhere to the prescribed regimen.

How Pharmaceutical Companies Use Moriskyscale MMAS4 and MMAS8:

Screening Participants
Prior to enrolling patients in clinical trials, pharmaceutical companies often use the Moriskyscale to identify potential non-adherence issues. This helps in selecting a more representative study population.

Measuring Adherence During Trials
The scales are employed to continuously monitor adherence throughout the trial. This data helps to account for adherence in the analysis of the medication's effectiveness.

Understanding Reasons for Non-Adherence
By using the MMAS8, pharmaceutical companies can delve into the specific domains and dimensions contributing to non-adherence. This information can guide targeted interventions.

Improving Medication Regimens
Insights from the Moriskyscale may lead to adjustments in medication regimens or the development of support programs to enhance adherence.