Psychometric properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: a systematic review and meta-analysis

Abstract Background Medication adherence has a major impact on reducing mortality and healthcare costs related to the treatment of cardiovascular diseases and diabetes mellitus. The task of selecting the best PROM among the many available for this kind of patient is extremely important. This study aims to critically assess, compare and synthesize the quality of the measurement properties of patient-reported outcome measures to access medication adherence among patients with cardiovascular diseases and/or type 2 diabetes mellitus. Methods This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. The searches were performed in Web of Science, SCOPUS, PubMed, CINAHL, EMBASE, LILACS, PsycINFO, and ProQuest (gray literature). Results A total of 94 records including 24 different PROMs were included in the review. The records were published between 1986 and 2020, most of them were conducted in the United States, and in English language. The only PROM that reached the criteria of category A, e.g., that can be recommended for use and results obtained can be trusted is the ProMAS. The PROMs that shouldn’t be recommended for use (category “c”) are the MTA, LMAS-14, GMAS, MEDS, MNPS, MALMAS, ARMS-D, DOSE-Nonadherence, MGT, MARS-5, and A-14. The remaining PROMs, e.g., MMAS-8, SMAQ, DMAS-7, ARMS-12, MTA-OA, MTA-Insulin, ARMS-10, IADMAS, MAQ, MMAS-5, ARMS-7, and 5-item questionnaire were considered as having the potential to be recommended for use (category “b”). Conclusion ProMAS is the only PROM that could be considered trusted and recommended for use for patients with cardiovascular diseases and/or type 2 diabetes mellitus. However, another 12 PROMs has the potential to be recommended for use but need further studies to ensure their quality, according to COSMIN guideline for systematic reviews of PROMs. Systematic review registration PROSPERO CRD42019129109.