Psychometric evaluation of a Kurdish version of medication adherence report scale and beliefs about medication questionnaire in patients with cardiometabolic conditions

Objective: This study aimed to evaluate the psychometric properties of the Kurdish versions of the Medication Adherence Report Scale (MARS‐5) and specific domains (necessity and concern domains) of the Beliefs About Medication Questionnaire (BMQ) among patients with cardiometabolic conditions. Materials and Methods: In this cross-sectional study, patients with cardiometabolic conditions undergoing treatment for at least a year at various medical centres in Erbil, Iraq, from February to July 2023 were included. Translation and cultural adaptation of two tools: MARS-5 and specific domains (necessity and concern domains) of BMQ were done. principal component analysis, analysis of internal consistency, and test-retest reliability were performed. The correlation analysis between clinical indicators (including blood pressure, HbA1C, and lipid profiles) and the score of MARS-5 was done. Results: Among 407 patients, almost half of participants (52%) were female with a median age of 60 (ranging from 25 to 88 years). Principal component analysis confirmed one component for MARS-5, and two components (Specific-Necessity and Specific-Concern) for BMQ. Cronbach's alpha values were 0.87 for the MARS-5 and 0.91 and 0.89 for the necessity and concern domains of BMQ, respectively. The intraclass correlation coefficients ranged from 0.84 to 0.95 for both tools at baseline and after two weeks. There were significant correlations between the score of MARS-5 and HbA1c levels using the chi-square test and Spearman correlation (rho: -0.45, p<0.001), as well as with blood pressure levels (rho: -0.21 for systolic blood pressure, p<0.001 and -0.17 for diastolic blood pressure, p<0.05). Conclusion:The Kurdish versions of MARS-5 and BMQ specific domains (necessity and concern domains) have shown good psychometric properties in the study population hence are suitable to evaluate medication adherence and beliefs about medication in Kurdish-speaking populations. Keywords: Medication Adherence, cardiometabolic condition, psychometric evaluation