A recent study from Oman reveals how different tools for assessing medication adherence yield varying results, impacting patient support strategies in diabetes management.
Medication adherence remains a stubborn weak point in chronic disease care, and the stakes are high. The American Heart Association says more than half of prescribed medicines for long-term conditions are not taken as directed, while the CDC has linked poor adherence to more hospital admissions, higher costs and worse outcomes. In diabetes, where daily treatment decisions shape long-term risk, that gap can affect everything from glucose control to complications.
A study from Sultan Qaboos University Hospital in Oman adds a local comparison of three common ways to measure that behaviour in adults with type 2 diabetes. The researchers compared the 8-item Morisky Medication Adherence Scale, a single-question self-assessment and the Arabic version of the Medication Adherence Universal Questionnaire in 233 patients seen between October 2024 and January 2025. The patients were mostly middle-aged, had longstanding diabetes and carried a heavy burden of comorbidity, including hypertension, dyslipidaemia and microvascular complications.
The tools did not tell the same story. The single-item question classified far more patients as highly adherent than the longer Morisky scale, yet agreement between the two was only slight to fair once chance was taken into account. The Morisky score also tracked more closely with glycated haemoglobin, or HbA1c, a routine marker of longer-term blood sugar control. By contrast, the single-question measure did not independently predict glycaemic control, suggesting it may be useful as a quick screen but less reliable as a stand-alone assessment.
The Arabic questionnaire added further nuance. Overall scores did not line up strongly with HbA1c, but one behavioural domain, lack of discipline, showed a modest link with the Morisky score. That fits broader evidence that adherence is shaped by beliefs, health literacy, side effects, regimen complexity, access to care and social support, as outlined in Nature Index and a systematic review of psychosocial predictors. The Omani study’s authors argue that these findings support a more careful choice of adherence tool in routine care, especially when the aim is to identify patients who may need counselling rather than simply record a yes-or-no answer.
Still, the research has limits. It was cross-sectional, used self-reported measures only and was done in a single tertiary hospital, so it cannot prove that one tool is clinically superior. Even so, it reinforces a simple point familiar across chronic disease care: how adherence is measured can change who is identified as at risk, and that can shape the support patients receive.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
