Development and Validation of Treatment Adherence Scale for Type 2 Diabetes Mellitus

Introduction: Adherence to treatment is crucial in long-term diabetes outcome, and treatment includes many different domains, but when most adherence studies have only focused on medication adherence, few studies have focused on diet, physical activity, and self-care. There is a need to have comprehensive scale which can assess all the domains together. This study aimed at development and validation of treatment adherence scale for type 2 diabetes mellitus. Materials and Methods: An initial version of Comprehensive Treatment Adherence Scale (CTAS) was prepared based on literature review and identification of key components. Then experts' opinion, further review of literature, pilot study, led to many changes in the scale. Finally, a 7-domain CTAS was developed. 240 patients' data were collected and practicing doctors' interviews were taken for the final version of the scale. The study was carried out in Pimpri, Pune, India using convenience sampling. Statistical Analysis: For reliability of the scale, Cronbach's a was used. Intra-item correlation and inter item correlation were done. Categorical variables were expressed in terms of frequency and percentages (where applicable). Results: The Cronbach's a coefficient was 0.829 for scale. Inter item correlation for scale between different domains was found to have wide range from +0.188 to +0.736 (P < 0.01). The study found that only 105 (43.57%) were advised about all the seven domains of the treatment. Out of 240 patients, 50 (20.83%), 141 (58.75%), 44 (18.33%), and 5 (2.08%) showed excellent, satisfactory, unsatisfactory, and poor treatment adherence, respectively. Conclusion: The CTAS for diabetes includes all the important aspects of the treatment. The scale also helps in maintaining a standard treatment protocol for diabetes.