A simplified medication adherence questionnaire (SMAQ) can be used to determine if a patient is adherent to a drug regimen. This can help identify a patient who needs closer monitoring or an intervention to increase compliance. The authors are from multiple hospitals in Spain.



(1) Do you ever forget to take your medicine? (Yes or No)

(2) Are you careless at times about taking your medicine? (Yes or No)

(3) Sometimes if you feel worse, do you stop taking your medicines? (Yes or No)

(4) Thinking about the last week, how often have you not taken your medications? (number of times dose missed)

(5) Did you not take any of your medicine over the past weekend? (Yes or No)

(6) Over the past 3 months, how many days have you not taken any medicine at all? (total number of days missed)



• I can see difficulty with consistent understanding of the 5th question. I interpret it as meaning that the person did not take any medications over the weekend.

• The Yes/No responses could be replaced by more options (always, sometimes, never, etc.).

• The significant levels for number of times or days when medications were not taken would vary with the regimen. For HIV regimens, risk increased when 3 or more doses were missed or when medications were not taken for 3 or more days.

• It would be necessary to make sure that the missed doses were not part of a scheduled drug holiday.

• For a person taking multiple medications, it might be necessary to determine how many drugs showed the poor compliance.

• When implementing the questionnaire, there needs to be a check to make sure that the person indicates no drugs were taken over the past weekend, yet state no days were missed during the past 3 months.


Criteria for a positive SMAQ:

(1) a positive response to any of the qualitative questions (items 1, 2 or 3).

(2) more than 2 doses were missed over the past week (items 4 and 5)

(3) more than 2 days of total non-medication during the past 3 months (item 6)



• In HIV patients on anti-retroviral regimens, adherent patients by the questionnaire were more likely to have undetectable viral load studies than nonadherent patients.

• The Cronbach alpha was 0.75, with interobserver agreement at 88.2%.


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