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Walsh JC, Dalton M, Gazzard BG. Adherence to combination antiretroviral therapy assessed by anonymous patient self-report. AIDS. 1998 Dec 3;12(17):2361-3

Responses to a 1 month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome

Effectively measuring adherence to medications for systemic lupus erythematosus in a clinical setting

The effective tool for self-assessment of adherence to treatment in patients with benign prostatic obstruction and overactive bladder symptoms.

The MASRI is a 12-item questionnaire of self-reported medication adherence addressing the frequency (6 items, part A) and the correct timing of medication intake (6 items, part B)

The first section related to the amount of medication actually taken. A permissive statement prefaced this section in order to encourage accurate responses. Two response formats were used: Likert scales (LS) and a visual analogue scale (VAS).

There were five LS items: questions 1 to 3 were: ‘How many doses of medication did you miss … yesterday?', ‘ … the day before yesterday?’ and ‘ … the day before that (3 days ago)?'. Possible responses were 0, 1, 2, 3 or don't know.

Item 4 asked ‘How many doses of medication have you missed in the 2 weeks before that?’ and possible responses were 0, 1, 2 or more, all of them, or don't know. Patients responding ‘2 or more’ were asked to state ‘roughly how many?'

Item 5 was ‘When was the last time you missed a dose of medication?’ Responses were: today, yesterday, earlier this week, last week, less than a month ago, more than a month ago, never or don't know. For analytical purposes responses of ‘never’ or ‘more than a month ago’ were grouped together, as it was not possible to differentiate them by MC.

The visual analogue scale (VASDOSE) was a VAS for the proportion of doses taken in the preceeding month. The instructions for VASDOSE read: ‘put a cross on the line below at the point showing your best guess about how much medication you have taken in the last month. We would be surprised if this was 100% for most people, e.g. 0% means you have taken no medication; 50% means you have taken half your medication; 100% means you have taken every single dose of medication'. VASDOSE ranged from 0 to 100% in 10% intervals. Participants whose period of observation was less than 25 days were excluded from analyses relating to reported adherence over the preceding month.

The second part of the MASRI addressed the timing of doses. The first four items used the same stem: ‘In the last month, how much of your medication did you take … at the time you were supposed to?’ Items 1–4 then added (1) ‘at the exact time (to within a few minutes)', (2) ‘within half an hour', (3) ‘within 1 hour or (4) ‘within 2 hours of the time you were supposed to?’ Possible responses on an LS were ‘none, very little, less than half, about half, more than half, nearly all or all'.

In the final two items, participants were asked to indicate on a VAS from 0–100% the proportion of doses taken within 2 hours of the correct time (VAS<2h) or more than 2 hours late (VAS2hLATE). The language of MASRI was English with a Flesch reading ease score of 91.3

Given that, unlike HIV therapy, the intake of medications at certain exact time intervals is an uncommon demand for patients with SLE or patients with other rheumatic diseases, the MASRI part B was not completed by the study participants