Protocol - Adherence to Medication Regimens
- Antipsychotic Medication Adherence
- Cigarette Smoking Status - Adult
- Health Literacy
- Medications (Current and Past Use of Pain Relievers, Statins, and Steroids)
- Smoking Quit Attempts
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.
Availability
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).
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 Category | Required |
|---|---|
| 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, Spanish, Other languages available at source
Standards
| Standard | Name | ID | Source |
|---|
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 ID | Variable Description | dbGaP Mapping |
|---|
Measure Name
Adherence to Medication Regimens
Release Date
February 14, 2022
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.