Validation and feasibility testing of a novel questionnaire to identify barriers to medication adherence

Principal Investigator: Debi Bhattacharya, University of East Anglia

  • Between a third and a half of patients prescribed medicines for long term conditions do not take them as prescribed. 
  • There is no effective tool for determining patient barriers to adherence in order to guide implementation of appropriate support. 
  • We report testing of the Identification of Medication Adherence Barriers Questionnaire (IMAB-Q) which was developed by the research team to identify patient barriers to adherence in routine care 
  • Nine pharmacies distributed the IMAB-Q to patients. A small sample of patients completed the questionnaire twice to test reliabilityPharmacists used IMAB-Q in medicines use reviews (MURs) to explore feasibility in practice and were interviewed to capture their thoughts and experiences of using it. 
  • The pharmacists thought IMAB-Q could be useful for identifying adherence barriers in an MUR and especially for raising topics not routinely discussed.  
  • A valid response to all 30 IMAB-Q questions was obtained from 608 (92.12%) completed questionnaires indicating good readability. The most common adherence barriers were emotions and beliefs about consequences which are not topics routinely discussed during MURs. 
  • Analysis defined a 10 item IMAB-Q which accurately identified non-adherent patients as they were significantly (p = 0.001) more likely to report barriers to adherence. The IMAB-Q was reliable when repeated.  
  • In the future we plan to test whether the 10 item IMAB-Q helps pharmacists to select appropriate interventions for non-adherent patients to improve health outcomes. We intend that IMAB-Q be used as a standard tool to guide and thus improve MURs and other adherence related consultations.

This project ran from June 2014 to May 2016. The final report is available here.