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This study develops and validates an instrument to measure medication adherence in hypertensive patients.

January 10, 2026Journal of Health Research0 citationsOpen Access

Development and Validation of Instruments to Measure Medication Adherence in Hypertensive Patients (MAHP): The Indonesian Case

BIBurhannudin IchsanMuhammadiyah University of Surakarta EHErna HerawatiMuhammadiyah University of Surakarta SBSri W. BasukiMuhammadiyah University of Surakarta

Key Result

The MAHP scale, comprising four domains and eleven items, has shown sufficient evidence of validity in measuring medication adherence among hypertensive patients.

Key Points

This study develops and validates an instrument to measure medication adherence in hypertensive patients.
Scale construction and validation methods
Defined constructs and domains related to medication adherence
Conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA)
Tested reliability using Cronbach’s alpha
EFA identified four domains relevant to medication adherence
CFA confirmed the model's good fit
Instrument consists of eleven items to assess medication adherence

Structured PICO

Population

Hypertensive patients in Indonesia (for scale validation) and individuals aged 15+ and 18+ in Indonesia (for national health survey)

Intervention

Development and validation of the Medication Adherence in Hypertensive Patients (MAHP) scale

Outcome

Validity and reliability of the MAHP scale (assessed via EFA, CFA, and Cronbach's alpha)patient reported

A new 11-item instrument (MAHP) was validated to measure medication adherence in Indonesian hypertensive patients, against a backdrop of high national prevalence and inadequate treatment-seeking behavior.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: Hypertension is a chronic disease that poses a significant public health issue globally. Medication adherence among hypertensive patients remains low, leading to various complications that adversely affect individuals, families, and the broader economy and society. To our knowledge, no specific instrument exists to measure medication adherence in hypertensive patients (MAHP) exclusively. This study aims to develop and validate an instrument to measure medication adherence and adherance-related behaviors among hypertensive patients. Methods : The research consisted of two methods: (1) scale construction and (2) scale validation. The construction phase included: (1) defining the construct and its domains, (2) item development, (3) expert review using the Content Validity Index (CVI), and (4) assessing readability through response process testing. The validation phase included: (1) exploratory factor analysis (EFA), (2) confirmatory factor analysis (CFA), and (3) reliability testing using Cronbach’s alpha. Results : EFA revealed four domains consistent with those identified through literature review and focus group discussions. However, item allocation led to renaming of certain domains. CFA confirmed that the resulting model had good fit. Conclusion : The MAHP scale, consisting of four domains and eleven items related to medication adherence in hypertensive patients, has demonstrated sufficient evidence of its validity. Keywords : Hypertension, Instrument, Medication adherence, Hypertensive patients, Indonesia

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