***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE : To review the literature on strategies to optimize medication adherence in community-dwelling older adults and to make recommendations for clinical practice . METHODS : A systematic literature search was conducted using the MEDLINE , CINAHL , PsycINFO , International Pharmaceutical Abstract s , and EMBASE data bases for r and omized controlled trials examining strategies to optimize medication adherence in patients aged 65 or older prescribed long-term medication regimens . Additional studies were found by examining the reference lists of systematic review s and selected papers . 34 papers reporting on 33 studies met the eligibility criteria and were included in this review . RESULTS : Improvement in adherence was mixed across the studies examining educational interventions , with only 12 of the 28 studies showing improvement in adherence ; most were delivered by pharmacists . Effect sizes for the statistically significant educational interventions ranged from Cohen 's d = 0.14 to 4.93 . Four of the 5 interventions using memory aids and cues , some in conjunction with newer technologies , improved adherence . Effect sizes for the statistically significant interventions using memory aids and cues ranged from Cohen 's d = 0.26 to 2.72 . CONCLUSION : The evidence from this review does not clearly support one single intervention to optimize medication adherence in older patients . Future studies should explore suggestive strategies , such as tailored interventions involving ongoing contact , and should endeavor to correct method ologic weaknesses found in the literature Objective This study examined the psychometric properties of the Korean version of the eight-item  Morisky Medication Adherence Scale ( MMAS-8 ) to measure adherence to diabetes medication in patients with type 2 diabetes mellitus . Methods The English version of the MMAS-8 was translated into Korean and administered to patient with type 2 diabetes mellitus via face-to-face interviews  , conducted by an independent interviewer . Patient characteristics and glycosylated haemoglobin ( HbA1c ) levels were assessed at the same clinic visit . A proportion of patients was r and omly selected for 2-week test-retest reliability via telephone interviews . Convergent validity of the MMAS-8 against a four-item MMAS , correlations with HbA1c levels and construct validity of the MMAS-8 were evaluated . Results In total , 317 patients were included ; 70 completed the 2-week test – retest interview . Internal consistency reliability was moderate and test – retest reliability of the MMAS-8 was excellent , although a ceiling effect was detected . Good convergent validity was shown by the high correlation of the new scale scores with the original MMAS-4 . A significant association was found between MMAS-8 scores and HbA1c levels . Using glycaemic control as a gold st and ard , sensitivity was 74.1 % and specificity was 38.3 % . Explanatory factor analysis identified three dimensions of the scale . Conclusions In light of acceptable reliability and validity , the MMAS-8 is a simple and quick method for the assessment of medication adherence among patient with type 2 diabetes mellitus , in a busy clinic setting Background The clinical benefits of any new treatment depend substantially on patient acceptance and treatment satisfaction , because only well-accepted treatments will be widely used . Thus , it is important to underst and how patients experience a new treatment . Objective This study assessed the psychometric properties of a question naire ( PRAM-TSQ ) design ed to measure treatment satisfaction in patients using pramlintide ( an analog of amylin , a glucoregulatory hormone co-secreted with insulin ) , which is design ed to improve glucose control . Methods Patients with diabetes completed the 14-item PRAM-TSQ  at the end of 2 separate placebo-controlled , double-blind , r and omized clinical trials in which they added active or placebo pramlintide to their established insulin regimen . Factor analysis was used to assess item clustering for the PRAM-TSQ , and the Cronbach 's α measure of inter-item agreement was used to assess scale reliability . PRAM-TSQ validity was assessed by comparing scores between treatment arms , and effect sizes were measured by the η statistic . Validity was also assessed by associations ( Pearson correlations ) between the PRAM-TSQ and clinical study outcomes ( end of study values and during study changes in clinical measures : postpr and ial glucose [ PPG ] , A1C , weight , and insulin requirements ) . Results Scaling revealed 4 PRAM-TSQ components : Global Benefits , Specific Benefits , Absence of Side Effects , Treatment Preference . The total composite PRAM-TSQ had good reliability in both studies ( type 1 α = .93 ; type 2 α = .94 ) ; subscale reliabilities ranged from .65 to 94 . Composite scores differed for pramlintide-treated and placebo-treated  patients ( type 1 P < .01 ; type 2 P < .05 ) , and were associated with lower PPG , weight , and insulin requirements ( all P < .05 ) . Results were similar for PRAM-TSQ subscales assessing Global Benefits and Treatment Preference ; Specific Benefits subscale scores were associated with lower PPG and weight ( all P < .05 ) . Conclusions The PRAM-TSQ shows evidence of being a valid , reliable instrument for assessing treatment satisfaction in patients using pramlintide . The subscales are comprehensive and sensitive to the known potential effects of pramlintide treatment . Diabetes educators can use patient responses to the PRAM-TSQ to facilitate treatment adherence by reminding patients of treatment benefits they experience and by helping patients overcome negative effects they report Background We examined the psychometric properties of the Korean version of the 8-item Morisky Medication Adherence Scale ( MMAS-8 ) among adults with hypertension . Methods A total of 373 adults with hypertension were given  face-to-face interviews in 2 cardiology clinics at 2 large teaching hospitals in Seoul , South Korea . Blood pressure was measured twice , and medical records were review ed . About one-third of the participants ( n = 109 ) were r and omly selected for a 2-week test-retest evaluation of reliability via telephone interview . Results Internal consistency reliability was moderate ( Cronbach α = 0.56 ) , and test-retest reliability was excellent ( intraclass correlation = 0.91 ; P < 0.001 ) , although a ceiling effect was detected . The correlation of MMAS-8 scores with scores for the original 4-item scale indicated that convergent validity was good ( r = 0.92 ; P < 0.01 ) . A low MMAS-8 score was significantly associated with poor blood pressure control ( χ2 = 29.86 ; P < 0.001 ; adjusted odds ratio = 5.08 ; 95 % CI , 2.56–10.08 ) . Using a cut-off point of 6 , sensitivity and specificity were 64.3 % and 72.9 % , respectively . Exploratory factor analysis identified 3 dimensions of the scale , with poor fit for the 1-dimensional construct using confirmatory factory analysis . Conclusions The MMAS-8 had satisfactory reliability and validity and thus might be suitable for assessment and counseling regarding medication adherence among adults with hypertension in a busy clinical setting in Korea Background : The ASK-20 survey is a previously vali date d patient-report measure of barriers to medication adherence and adherence-related behavior . Objective : To derive and vali date a shorter version of the ASK-20 scale . Methods : Patients with asthma , diabetes , and congestive heart failure were recruited from a university medical center . Participants completed the ASK-20 survey and other question naires . Approximately one-third of participants were r and omized to a 2-week retest administration . Item performance and results of an exploratory factor analysis were examined for item reduction and subscale identification . Subsequent analyses examined reliability and validity of the shorter version of the ASK . Results : A total of 112 patients participated ( 75.9 % female ; mean age 46.7 y ; 53.6 % African American ) . Eight items were dropped from the ASK-20 based on factor loadings , floor effects , Cronbach 's α , and the ability of each item to discriminate between groups of patients differing in self-reported adherence . The new total score ( ASK-12 ) had good internal consistency reliability ( Cronbach 's α 0.75 ) and test-retest reliability ( intraclass correlation 0.79 ) . Convergent validity was demonstrated through correlations with the Morisky Medication Adherence Scale ( r -0.74 ; p < 0.001 ) , condition-specific measures , the SF-12 Mental Component Score ( r –.32 ; p < 0.01 ) , and proportion of days covered by tilled medication prescriptions in the past 6 months as indicated by pharmacy cl aims data ( r -0.20 ; p = 0.059 ) . The ASK-12 total score also discriminated among groups of patients who differed in self-reported adherence indicators , including whether a dose was missed in the past week , the number of days medication was not taken as directed , and treatment satisfaction . Three subscales were identified ( adherence behavior , health beliefs , inconvenience/forgetfulness ) , and results provided initial support for their validity . Conclusions : The ASK-12 demonstrated adequate reliability and validity , and it may be a useful brief measure of adherence behavior and barriers to treatment adherence The Hill-Bone Compliance to High Blood Pressure Therapy Scale assesses patient behaviors for three important behavioral domains of high blood pressure treatment : 1 ) reduced sodium intake ; 2 ) appointment keeping ; and 3 ) medication taking . This scale is comprised of 14 items in three subscales . Each item is a four point Likert type scale . The content validity of the scale was assessed by a relevant literature review and an expert panel , which focused on cultural sensitivity and appropriateness of the instrument for low literacy . Internal consistency reliability and predictive validity of the scale were evaluated using two community based sample s of hypertensive adults enrolled in clinical trials of high blood pressure care and control . The st and ardized alpha for the total scale were 0.74 and 0.84 , and the average interitem correlations of the 14 items were 0.18 and 0.28 , respectively . The construct and predictive validity of the scale was assessed by factor analysis and by testing of theoretically derived hypotheses regarding whether the scale demonstrated consistent and expected relationships with related variables . In this study , high compliance scale scores predicted significantly lower levels of blood pressure and blood pressure control . Moreover , high compliance scale scores at the baseline were significantly associated with blood pressure control at both baseline and at follow up in the two independent sample s. This brief instrument provides a simple method for clinicians in various setting s to use to assess patients ' self reported compliance levels and to plan appropriate interventions Background : Patient self-report is a practical method for measuring adherence , but little is known about its optimal use . Objectives : To examine the retest reliability and predictive validity of 3 different types of self-report adherence measures among patients with common chronic illnesses . Research Design : Correlation and regression analyses of data from an ongoing r and omized controlled trial . Subjects : Patients ( N = 415 ) aged ≥40 years recruited from a primary care network with arthritis , asthma , chronic lung disease , congestive heart failure , depression , and /or diabetes mellitus , plus impairment in ≥1 basic activity and /or a score of ≥4 on the 10-item Center for Epidemiologic Studies Depression Scale . Measures :  Self-report adherence  ( administered variously at baseline , 2 , 4 , and 6 weeks , and 6 months ) : number of pills taken/number of pills prescribed  ( PT/PP ) , using 1–7 days recall , and global reports of medication adherence and overall adherence tendencies . Six-month functional outcomes : Health Assessment Question naire ( HAQ ) and Short Form-36 ( SF-36 ) . Results : Correlation coefficients among contemporaneously administered 1–7 days PT/PP measures were ≥0.78 . Correlations among PT/PP measures and global adherence measures , and among PT/PP measures at 2 and 4 weeks , ranged from 0.11 to 0.54 . PT/PP measures using ≥3–4 days recall significantly predicted adjusted 6-month HAQ but not SF-36 score . Conclusions : Self-report PT/PP and general medication adherence measures tap different behavioral constructs . Self-reported PT/PP at a given point in time is not necessarily representative of medication adherence over time . Among chronically ill patients , 3–4 days recall of PT/PP yield adherence estimates , which are practically as reliable and valid as longer intervals and which predict functional outcomes 
    Output:
    
The MMAS-8 ( Morisky Medication Adherence Scale–8 items ) and the Hill-Bone scale  were the most frequently used instruments .
They were found to be well vali date d , with strong evidence for internal consistency and strong positive evidence for reliability , structural validity , hypothesis testing , and criterion validity .
Conclusions The MMAS-8 and Hill-Bone scale seem to be well-vali date d instruments for assessing medication adherence in adults at risk for metabolic syndrome .