Reliability and Validity Assessment of the General Medication Adherence Scale among Breast Cancer Patients in Pakistan.

Authors

Daniya Noreen, Sadia Shakeel, Najia Rahim, Sana Shamim, Fakhsheena Anjum, Ale Zehra, Ghulam Haider, Ayesha Shakeel Ahmed

Published in

Asian Pacific journal of cancer prevention : APJCP. Volume 27. Issue 6. Pages 2225-2234. Jun 01, 2026. Epub Jun 01, 2026.

Abstract

Adherence rates to adjuvant therapy for breast cancer are often suboptimal, which raises the risk of recurrence, lowers survival rates, and increases healthcare expenses. The present study aimed to assess the validity and reliability of the General Medication Adherence Scale (GMAS) in identifying adherence to adjuvant cancer therapy (ACT) in breast cancer patients.
A prospective, cross-sectional study was conducted on breast cancer patients using the Urdu version of the GMAS. Reliability was assessed using Cronbach's alpha (α) and inter-item correlations. The instrument was subjected to principal component factor analysis (PCFA) with varimax rotation. Exploratory factor analysis (EFA) and PCFA were performed using IBM SPSS version 23, while confirmatory factor analysis (CFA) was carried out using IBM AMOS version 25.
Cronbach's alpha of the GMAS was found to be 0.882, confirming that the scale has good reliability. The mean score was significantly different among items ensuring the significance of each item in the GMAS scale (Tukey's test p< 0.0001; Chi-square=38.825, p< 0.0001). A total of 204 female responses were recorded; the mean age was 41.2±9.5 years. It was observed that n=95 (46.5%) of patients showed partial adherence whereas n=76 (37.2%) patients were highly adherent to ACT. The probability of patients' adhering to their therapy was greater among those who were employed [OR = 1.95, 95% CI (1.27, 2.62)] and have higher level of education [OR = 2.93, 95% CI (1.39, 4.46)]. The potential reasons for non-adherence were the cost of treatment n=44 (21.5%), adverse effects n=33 (16.1%), depression and emotional stress n=32 (15.6%).
The Urdu version of GMAS, validated with good internal reliability, proved to be a feasible and accurate tool for measuring adherence among breast cancer patients.

PMID:
42345171
Bibliographic data and abstract were imported from PubMed on 25 Jun 2026.

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