Adherence refers to the extent patient behavior matches advice from health care providers. Non-adherence should not be a reason to blame the patient

The reason why the Morisky scales are highly validated is because of the way the questions are phrased to avoid “yes saying” bias. The MMAS-8 was conceptualized to reduce victim blaming by reversing the direction of the question. The MMAS-8 never asks the patient "Do you always take your high blood pressure medication" because 90% of my patients will say "yes, doctor" because they don’t want to be blamed for not taking their medication. So, we ask in the negative direction, "Do you sometimes forget to take your high blood pressure medication"? Now about 50% will respond "yes".