A new 15-item Traditional Chinese questionnaire, tested in Taiwanese community pharmacies, offers a rapid and practical tool for pharmacists to identify patients struggling with medication adherence, potentially improving long-term diabetes management outcomes.
A Traditional Chinese version of a 15-item medication adherence questionnaire has been translated and tested in Taiwanese community pharmacies, with researchers saying it could help pharmacists identify patients who are missing doses or struggling with practical barriers to treatment.
The instrument, known as the 15-item Screening Tool for AdheRence to medicineS, was adapted from English into Traditional Chinese and then field-tested among people with type 2 diabetes in pharmacies linked to National Taiwan University. The study found that the tool was clear, acceptable to both pharmacists and patients, and practical to complete during routine visits, taking about five to ten minutes to administer.
Medication adherence remains a major challenge in chronic disease care. As the World Health Organisation and other health bodies have long noted, about half of people with long-term conditions do not take medicines as prescribed, a pattern linked to worse health outcomes, more hospital care and higher costs. A study published on PubMed Central focused on type 2 diabetes found that poor adherence is associated with worse glycaemic control, greater healthcare use, higher spending and increased mortality.
The Taiwan team said the appeal of the 15-item tool lies in its breadth and speed. Unlike a single yes-or-no question about whether a patient takes medicine properly, the questionnaire probes forgetfulness, concerns about side effects, beliefs about too many medicines, stopping treatment when feeling better and the need for pharmacist support. In community pharmacy practice, where consultations are often brief, the researchers argued that a short, free questionnaire can uncover more useful detail than a general adherence check.
The field test included 215 people with type 2 diabetes, with a mean age of 65.3 and a response rate above 90%. Just over half said they had not missed any doses in the previous two weeks, but nearly one in three reported missing one or two doses, and almost half identified at least one reason for non-adherence. Forgetfulness was the most common problem, followed by the burden of multiple medicines and worries about adverse effects.
The findings also reflect broader adherence research from organisations including Walgreens, the American Heart Association and the NHS Specialist Pharmacy Service, all of which point to the same recurring barriers: complex regimens, poor communication, side-effect concerns and simple forgetfulness. The Taiwan study adds a local dimension by showing that these issues are common in a setting where cost-related barriers appear less prominent, likely because of the country’s universal health insurance system.
Researchers said the translated questionnaire showed satisfactory content validity and good consistency across the set of belief-based items. They also found some agreement with another adherence scale already used in Taiwan, although one refill-based measure did not line up as closely. That distinction matters, they said, because self-reported behaviour and refill records capture different aspects of medicine use.
The study’s authors concluded that the Traditional Chinese 15-item tool is best viewed as a screening aid rather than a definitive measure of whether patients are truly adhering to treatment. Used alongside pharmacy records and clinical data, they said, it could help pharmacists start more targeted conversations and tailor support for people at risk of non-adherence.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
