Translation and Validation of a Simplified Medication Adherence Questionnaire and Factors Affecting Chronic Diseases Medication Adherence among Arab Americans

Abstract

Background: The Arab American population is growing in the United States, and limited information is available about their medication adherence and the factors that impact their adherence to medication. The limited data available on Arab Americans showed that this population has a high prevalence of chronic diseases and a low level of adherence to medications.

Objective: The purpose of this study was to translate and to validate the Arabic version of the Simplified Medication Adherence Questionnaire (SMAQ), and to study the factors that affect medication adherence among Arab Americans.

Methodology: A cross-sectional study was conducted in two phases, the validation and main phases. All Arab patients were recruited from five collaborating clinics in Northern Virginia. Descriptive analyses were used for both phases. In the validation phase, the SMAQ was translated into Arabic and validated using factor analyses, reliability analysis, the Fisher exact test, and Pearson correlation. For the main study, simple and multiple logistic regression, and simple and multiple linear regression analyses were performed to study the predictors of medication adherence. All analyses were performed using SPSS version 26.

Results: There were 35 patients in the validation phase, 60% of them were 65 years or older, 62.9% were male, and 74.3% were not adherent to medication. Cronbach’s alpha was 0.614. The Pearson correlation was significant (r = −0.413, p = 0.015). As for the main study, of the 120 participants, 64.2% were non-adherent to medication. Only exercise was a significant predictor of medication adherence among Arab Americans (p = 0.047).

Conclusion: The Arabic version of the Simplified Medication Adherence Questionnaire proved to be a valid and reliable scale to be utilized by researchers for medication adherence measurement in Arabic speaking populations. The adherence level among Arab Americans was lower than that seen in the general U.S. population. More research is needed for the Arab American population in different states and on a larger sample size to give more substantial evidence about the factors impacting adherence and to assess the burden of chronic diseases in this growing portion of the population.