title: Concordance of Pharmacist Assessment of Medication Nonadherence With a Self-Report Medication Adherence Scale.
abstract: OBJECTIVE
  To evaluate the concordance of the Modified Morisky Scale (MMS) with a pharmacist assessment of medication adherence during a medication review.
  
  
  METHODS
  This retrospective study examined the electronic medical records (EMRs) of patients ≥18 years who received a medication review by a pharmacist from October 2008 to September 2009 at a homeless behavioral health clinic. In addition to the 6-item MMS, adherence was assessed using the first 4 items of the MMS, which comprise the original Morisky Scale. A final pharmacist assessment of adherence based upon the medication review was documented in the EMR. The McNemar test was used to assess the agreement between the MMS (6 and 4 items) and the pharmacist assessment of medication adherence.
  
  
  RESULTS
  A total of 288 patients were eligible for the study, which included 449 medication reviews. Nonadherence was identified in 61.7% and 49.7% of medication reviews using the 6 and 4 items of the MMS. The pharmacist assessment determined nonadherence in 23.8% of medication reviews. There were significant differences between the pharmacist adherence assessment and the 6 (P < .0001) and 4 (P < .0001) items of the MMS.
  
  
  CONCLUSIONS
  A combination of methods including self-report and pharmacist assessment may provide the greatest insight into adherence.
authors.affiliation: School of Pharmacy, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kelly
authors.affiliation: Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, VA, USA lrmoczygemba@vcu.edu.
authors.forename: Leticia R
authors.initials: LR
authors.lastname: Moczygemba
authors.affiliation: Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Sharon S
authors.initials: SS
authors.lastname: Gatewood
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D059065:Medication Reconciliation / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D010595:Pharmacists / Q000592:standards*; D024382:Professional Role; D012189:Retrospective Studies; D057566:Self Report / Q000592:standards*
keywords: medication adherence; medication therapy review; pharmacist; self-report scale