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Peer-reviewedCC BY-NC 4.0Asian Pacific Journal of Cancer Prevention : APJCP

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

  • Daniya Noreen1
  • Sadia Shakeel2
  • Najia Rahim2
  • Sana Shamim3
  • Fakhsheena Anjum2
  • Ale Zehra2
  • Ghulam Haider4
  • Ayesha Shakeel Ahmed5
5 affiliations
  1. 1Dow Institute of Medical Technology, Dow University of Health Sciences, Karachi, Pakistan.
  2. 2Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan.
  3. 3Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan.
  4. 4Department of Clinical Oncology, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.
  5. 5Institute of Medical Technology, Jinnah Sindh Medical University, Karachi, Pakistan.
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Abstract

Background:: 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.

Method:: 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.

Results:: 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%).

Conclusions:: 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.

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Cite

BibTeXRIS
BibTeX
@article{noreen2026reliability,
  title = {{Reliability and Validity Assessment of the General Medication Adherence Scale among Breast Cancer Patients in Pakistan}},
  author = {Daniya Noreen and Sadia Shakeel and Najia Rahim and Sana Shamim and Fakhsheena Anjum and Ale Zehra and Ghulam Haider and Ayesha Shakeel Ahmed},
  journal = {Asian Pacific Journal of Cancer Prevention : APJCP},
  year = {2026},
  month = jun,
  doi = {10.31557/apjcp.2026.27.6.2225},
  url = {https://doi.org/10.31557/apjcp.2026.27.6.2225},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Reliability and Validity Assessment of the General Medication Adherence Scale among Breast Cancer Patients in Pakistan
AU  - Daniya Noreen
AU  - Sadia Shakeel
AU  - Najia Rahim
AU  - Sana Shamim
AU  - Fakhsheena Anjum
AU  - Ale Zehra
AU  - Ghulam Haider
AU  - Ayesha Shakeel Ahmed
PY  - 2026
DA  - 2026/06/20
JO  - Asian Pacific Journal of Cancer Prevention : APJCP
DO  - 10.31557/apjcp.2026.27.6.2225
UR  - https://doi.org/10.31557/apjcp.2026.27.6.2225
AB  - Background:: 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.  Method:: 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.  Results:: 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%).  Conclusions:: 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.
SN  - 1513-7368
SN  - 2476-762X
ER  -