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Protocol - Adherence to Medication Regimens

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Description

The Adherence to Refills and Medications Scale (ARMS) includes 12 self-reported items that assess a participant’s medication-taking behavior. The measure has two subscales: an 8-item subscale assessing a respondent’s ability to correctly administer a prescribed medication regimen, and a 4-item subscale assessing a respondent’s ability to refill prescriptions on schedule. The ARMS scale is suitable for use in respondents with chronic disease and among low-literacy respondents.

Specific Instructions

The Adherence to Refills and Medications Scale (ARMS) questionnaire is for academic and nonprofit purposes only. If your intention is to use the protocol in a for-profit or commercial environment, please contact the Emory OTT Licensing Team (OTTLegl@emory.edu) at Emory University to request permission and obtain licensing information before use. You may not translate or otherwise modify the tool. If a derivative work is created based on the ARMS, the work will be owned by Emory University. The Emory University copyright notice must be maintained on the ARMS. ARMS cannot be used in any research that is subject to 3rd-party rights (e.g., industry-sponsored research that grants rights to the sponsor) without a commercial license.

Although ARMS has not been validated for use with smoking cessation–related medications, the Smoking Cessation, Harm Reduction, and Biomarkers Working Group believes these questions are suitable for this purpose.

A person’s prescription medication use should first be assessed using the Medication Inventory protocol. To minimize the possible effect of literacy on responses, an interviewer places a printed response scale in front of the patient and orients the patient to the response items. The patient is told that s/he can respond verbally or by pointing to the desired response.

Protocol

I will now ask you how often you actually miss taking your medicines. There are no right or wrong answers. For each question, please answer “none of the time,” “some of the time,” “most of the time,” or “all of the time.”

None

Some

Most

All

1. How often do you forget to take your medicine?

1

2

3

4

2. How often do you decide not to take your medicine?

1

2

3

4

3. How often do you forget to get prescriptions filled?

1

2

3

4

4. How often do you run out of medicine?

1

2

3

4

5. How often do you skip a dose of your medicine before you go to the doctor?

1

2

3

4

6. How often do you miss taking your medicine when you feel better?

1

2

3

4

7. How often do you miss taking your medicine when you feel sick?

1

2

3

4

8. How often do you miss taking your medicine when you are careless?

1

2

3

4

9. How often do you change the dose of your medicines to suit your needs (like when you take more or less pill than you’re supposed to)?

1

2

3

4

10. How often do you forget to take your medicine when you are supposed to take it more than once a day?

1

2

3

4

11. How often do you put off refilling your medicines because they cost too much money?

1

2

3

4

12. How often do you plan ahead and refill your medicines before they run out?

1

2

3

4

© Emory University

Scoring Instructions

Item 12 should be reverse coded. Then add up the points. Lower scores indicate better adherence. Scores can be treated as a continuous measure or dichotomized as ≤12 or >12 (for the full ARMS).

Availability

Available

Personnel and Training Required

The interviewer should be trained in the administration of the Adherence to Refills and Medications Scale (ARMS). The interviewer should be trained to prompt respondents further if a “don’t know” response is provided.

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered questionnaire

Lifestage

Adolescent, Adult

Participants

Adolescent (12–18 years of age)

Adult (18+ years of age)

Selection Rationale

This protocol is low-burden, easy to use, and valid for evaluating adherence to medications for a range of health conditions including hypertension, coronary heart disease, dyslipidemia, and diabetes. The medication-taking and prescription-refill subscales capture different types of problems in adherence, allowing interventions to be tailored to those distinct concerns.

Language

Chinese, English, Korean, Polish, Spanish, Turkish

Standards
StandardNameIDSource
caDSR Common Data Elements (CDE) Adherence Medication Treatment Regimen Scale Assessment Score 8027703 CDE Browser
Derived Variables

None

Process and Review

Not applicable.

Protocol Name from Source

Adherence to Refills and Medications Scale (ARMS)

Source

Dharmapuri, S., Best, D., Kind, T., Silber, T. J., Simpson, P., & D’Angelo, L. (2015). Health literacy and medication adherence in adolescents. Journal of pediatrics, 166(2), 378–382.

Kripalani, S., Risser, J., Gatti, M. E., & Jacobson, T. A. (2009). Development and evaluation of the Adherence to Refills and Medications Scale (ARMS) among low-literacy patients with chronic disease. Value in Health : The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 12(1), 118–123.

General References

Chen, Y. J., Chang, J., & Yang, S. Y. (2020). Psychometric evaluation of Chinese version of Adherence to Refills and Medications Scale (ARMS) and blood-pressure control among elderly with hypertension. Patient Preference and Adherence, 14, 213–220.

Gökdoğan, F., & Kes, D. (2017). Validity and reliability of the Turkish Adherence to Refills and Medications Scale. International Journal of Nursing Practice, 23(5), 10.1111/ijn.12566.

Kim, C. J., Park, E., Schlenk, E. A., Kim, M., & Kim, D. J. (2016). Psychometric evaluation of a Korean version of the Adherence to Refills and Medications Scale (ARMS) in adults with type 2 diabetes. Diabetes Educator, 42(2), 188–198.

Lomper, K., Chabowski, M., Chudiak, A., Białoszewski, A., Dudek, K., & Jankowska-Polańska, B. (2018). Psychometric evaluation of the Polish version of the Adherence to Refills and Medications Scale (ARMS) in adults with hypertension. Patient Preference and Adherence, 12, 2661–2670.

Protocol ID

331001

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
Smoking Cessation, Harm Reduction and Biomarkers
Measure Name

Adherence to Medication Regimens

Release Date

January 1, 1970

Definition

Measure used to determine a respondent’s adherence to taking a prescribed medication.

Purpose

The purpose of this measure is to assess a respondent’s adherence to taking a prescribed medication. Adherence is a critical construct in determining an intervention’s effectiveness and safety, as well as translation potential.

Keywords

Smoking cessation, harm reduction, and biomarkers, adherence, study medication, intervention, Adherence to Refills and Medications Scale, ARMS, prescribed medication, prescribed medicine, prescription medication, prescription medicine

Measure Protocols
Protocol ID Protocol Name
331001 Adherence to Medication Regimens
Publications

There are no publications listed for this protocol.