"Medication Compliance Questionnaire (MCQ)" by Much Ilham Novalisa Aji Wibowo, Angelia Yuliana Safitri et al.
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ORCID ID

Much Ilham Novalisa Aji Wibowo: 0000-0002-2825-9781

Angelia Yuliana Safitri: 0009-0006-6688-7056

Didik Setiawan: 0000-0001-9104-548X

Abstract

Background: Medication adherence is critical for managing type 2 diabetes mellitus (T2DM). The Medication Compliance Questionnaire (MCQ) is a widely recognized tool for assessing adherence but has not been adapted for T2DM in Indonesia. This study aimed to adapt and validate the MCQ in the Indonesian socio-cultural context.

Methods: A cross-sectional study at community health centers (May–Aug 2024) involved forward/back translation, content validation using Aiken’s V, and psychometric assessment among 230 patients. Exploratory Factor Analysis (EFA) assessed construct validity, including convergent, discriminant, and reliability.

Results: Aiken's V index indicated strong content validity (average = 0.881). EFA identified two dimensions—practical adherence and patient perception—explaining 49.25% of the variance. Composite Reliability (CR) values exceeded 0.70, indicating good internal consistency. While the Average Variance Extracted (AVE) was below 0.50, CR ≥ 0.70 confirmed convergent validity. No significant cross-loadings supported discriminant validity.

Conclusion: The validated Indonesian version of the MCQ consists of six items, demonstrating strong validity and reliability. The two-factor structure reflects practical adherence and patient perception, making it a valuable tool for assessing medication adherence among Type 2 Diabetes Mellitus (T2DM) patients in Indonesia.

References

  1. Pavkov ME, Miyamoto Y. IDF ATLAS REPORTS: Diabetes and Kidney Disease. Belgium: International Diabetes Federation, 2023.
  2. Kementerian Kesehatan RI. Profil Kesehatan Indonesia 2021. Jakarta: Kementerian Kesehatan RI, 2021.
  3. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119.
  4. Badan Penyelenggara Jaminan Sosia. Laporan Pengelo-laan Program Tahun 2018 dan Laporan Keuangan Tahun 2018 [Internet]. Jakarta: Badan Penyelenggara Jaminan Sosia; 2018.
  5. Dal Canto E, Ceriello A, Rydén L, Ferrini M, Hansen TB, Schnell O, et al. Diabetes as a cardiovascular risk factor: An overview of global trends of macro and micro vascular complications. Eur J Prev Cardiol. 2019;26:25–32.
  6. Chaudhury A, Duvoor C, Dendi VSR, Kraleti S, Chada A, Ravilla R, et al. Clinical review of antidiabetic drugs: Implications for type 2 diabetes mellitus management. Front Endocrinol. 2017;8:6.
  7. Dewan Jaminan Sosial Nasional. Laporan Hasil Peng-awasan: Monitoring dan Evaluasi Penyelenggaraan Program Jaminan Kesehatan Nasional. Jakarta: Dewan Jaminan Sosial Nasional; 2023.
  8. Phrommintikul A, Dilokthornsakul P, Permsuwan U. Economic burdens for treatment of patients with type 2 diabetes in North Thailand: A hospital-based obser-vational study. Front Endocrinol. 2022;13:824545.
  9. Wibowo MINA, Fitri FM, Yasin NM, Kristina SA, Prabandari YS. Kepatuhan minum obat pada pasien diabetes melitus tipe 2 di beberapa puskesmas kabupaten Banyumas. Jurnal Kefarmasian Indonesia. 2021 31;11:98–108.
  10. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best practices for developing and vali-dating scales for health, social, and behavioral research: A primer. Front Public Health. 2018;6:149.
  11. Wibowo MINA, Yasin NM, Kristina SA, Prabandari YS. A systematic review on self-reported questionnaires to assess medication adherence in diabetic patients. Malay J Public Health Med. 2021;21:359–73.
  12. Ahmad NS, Ramli A, Islahudin F, Paraidathathu T. Medication adherence in patients with type 2 diabetes mellitus treated at primary health clinics in Malaysia. Patient Prefer Adherence. 2013;7:525–30.
  13. Aminde LN, Tindong M, Ngwasiri CA, Aminde JA, Njim T, Fondong AA, et al. Adherence to antidiabetic medication and factors associated with non-adherence among patients with type-2 diabetes mellitus in two regional hospitals in Cameroon. BMC Endocr Disord. 2019;19:35.
  14. Krousel-Wood M, Muntner P, Jannu A, Desalvo K, Re RN. Reliability of a medication adherence measure in an outpatient setting. Am J Med Sci. 2005;330:128–33.
  15. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67–74.
  16. Cruchinho P, López-Franco MD, Capelas ML, Almeida S, Bennett PM, Silva MMd, et al. Translation, cross-cultural adaptation, and validation of measurement instruments: A practical guideline for novice researchers. J Multidiscip Healthc. 2024;17:2701–28.
  17. Ortiz-Gutiérrez S, Cruz-Avelar A. Translation and cross-cultural adaptation of health assessment tools. Actas Dermosifiliogr. 2018;109:202–6.
  18. Taherdoost H. Data collection methods and tools for research; A step-by-step guide to choose data collection technique for academic and business research projects. Int J Acad Res Manag. 2021;10:10–38.
  19. Kyriazos TA. Applied psychometrics: Sample size and sample power considerations in factor analysis (EFA, CFA) and SEM in general. Psychology. 2018;9:2207–30.
  20. Ghavami V, Jamali J, Sarkhosh M. Assessment of construct validity faculty members’ evaluation questionnaire by students in health school of Mashhad University of medical sciences. Future Med Edu J. 2019;9:18–23.
  21. Heale R, Twycross A. Validity and reliability in quantitative studies. Evid Based Nurs. 2015;18:66–7.
  22. Matheson GJ. We need to talk about reliability: Making better use of test-retest studies for study design and interpretation. PeerJ. 2019;7:e6918.
  23. Jeldres MR, Costa ED, Nadim TF. A review of Lawshe’s method for calculating content validity in the social sciences. Front Educ. 2023;8:1271335.
  24. Scott PA. Ethical Principles in Healthcare Research. In Scott P, ed. Key Concepts and Issues in Nursing Ethics. Cham: Springer; 2017. p.191–205.
  25. Kania N, Kusumah YS, Dahlan JA, Nurlaelah E, Gürbüz F, Bonyah E. Constructing and providing content validity evidence through the Aiken’s V index based on the experts’ judgments of the instrument to measure mathematical problem-solving skills. Res Eval Educ. 2024;10:64–79.
  26. Vakili MM, Jahangiri N. Content validity and reliability of the measurement tools in educational, behavioral, and health sciences research. J Med Educ Dev. 2018;10:106–18.
  27. Yusoff MSB. ABC of content validation and content validity index calculation. Educ Med J. 2019;11(2):49–54.
  28. Braekman E, Berete F, Charafeddine R, Demarest S, Drieskens S, Gisle L, et al. Measurement agreement of the self-administered questionnaire of the Belgian health interview survey: Paper-and-pencil versus web-based mode. PLoS One. 2018;13:e0197434.
  29. Sakuramoto H, Hatozaki C, Unoki T, Aikawa G, Kobayashi S, Okamoto S, et al. Translation, reliability, and validity of Japanese version of the Respiratory Distress Observation Scale. PLoS One. 2021;16:e0255991.
  30. Orcan F. Exploratory and confirmatory factor analysis: Which one to use first? J Meas Eval Educ Psychol. 2018;9:414–21.
  31. Hair JF, Black WC, Babin B. J, Anderson RE. Multivariate Data Analysis. 7th ed. Pearson Education Limited; 2014.
  32. Watkins MW. Exploratory factor analysis: A guide to best practice. J Black Psychol. 2018;44:219–46.
  33. Ried L, Eckerd S, Kaufmann L. Social desirability bias in PSM surveys and behavioral experiments: Considerations for design development and data collection. J Purch Supply Manag. 2022;28:100743.
  34. Teh WL, Abdin E, Asharani PV, Kumar FDS, Roystonn K, Wang P, et al. Measuring social desirability bias in a multi-ethnic cohort sample: Its relationship with self-reported physical activity, dietary habits, and factor structure. BMC Public Health. 2023;23:415.
  35. DeVellis RF. Scale Development Theory and Applications. 4th ed. SAGE Publications: California; 2017.
  36. Kementerian Pendidikan, Kebudayaan, Riset, dan Teknologi. Kamus Besar Bahasa Indonesia VI [Internet]. Indonesia: Badan Pengembangan dan Pembinaan Bahasa; 2016.
  37. Al Hayyan AJ, Mei Wulan SM, Masduchi RH, Nugraheni N, Poerwandari D, Melaniani S, et al. Validity and reliability of the loco-check questionnaire after cross-cultural adaptation for Indonesia. J Orthop Sci. 2023;28:267–71.
  38. Phedy P, Djaja YP, Tobing SDAL, Gatam L, Librianto D, Fachrisal, et al. Cross-cultural adaptation and psycho-metric validation of the Indonesian version of the Oswestry Disability Index. Eur Spine J. 2021;30:1053–62.
  39. Solikhah S, Perwitasari DA, Rejeki DSS. Cross-cultural adaptation and psychometric properties of the Indo-nesian version for quality of life among breast cancer patients. Front Public Health. 2023;11:1069422.
  40. Roos JM, Bauldry S. Confirmatory Factor Analysis. USA: SAGE Publications; 2021. p.107.
  41. Brincks J, Callesen J. Examining the test-retest reliability and construct validity of the Six-Spot Step Test in older adults with self-reported balance problems. Clin Rehabil. 2021;35:1478–87.
  42. Purba FD, Hunfeld JAM, Iskandarsyah A, Fitriana TS, Sadarjoen SS, Passchier J, et al. Quality of life of the Indonesian general population: Test-retest reliability and population norms of the EQ-5D-5L and WHOQOL-BREF. PLoS One. 2018;13:e0197098.

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