MAQ

MAQ
Medication & Adherence Questionnaire
User Id*
Patient Id*
Administer and score questionnaire
- Patients who score 6 or higher are screened every 90 days.
- Patients who score less than 6 are screened 30 days later.
- Next screening date should be recorded in Active Issues.
  (Navigator should also add to their calendar.)
You are taking medication(s) for your chronic condition(s) such as:*
high blood pressurecongestive heart failure
People who take medication for health concerns may sometimes have issues with
their medication-taking, and we are interested in your experiences. There is no rightor wrong answer. Please answer each question based on your personal experience.

Navigators may self identify regarding difficulties they may experience concerning
medication-taking behavior. For instance, if truthful, the navigator can say
something like “I have trouble remembering to take medications myself
sometimes” or other normalizing experience may be shared.

	No= 1	Yes= 0
1. Do you sometimes forget to take your [health concern] pills?
2. People sometimes miss taking their medications for reasons other than forgetting. Thinking over the past two weeks, were there any days when you did not take your [health concern] medicine?
3. Have you ever cut back or stopped taking your medication without telling your doctor, because you felt worse when you took it?
4. When you travel or leave home, do you sometimes forget to bring along your [health concern] medication?
5. Did you forget to take your [health concern] medicine yesterday?
6. When you feel like your [health concern] is under control, do you sometimes stop taking your medicine?
7. Taking medication every day is a real inconvenience for some people. Do you ever feel hassled about sticking to your blood pressure treatment plan?

Never/Rarely= 1 Once in a while= .75 Sometimes= .5 Usually= .25 All the time= 0
8. How often do you have difficulty remembering to take all your medications?
Total (Maximum 8):
Source: Morisky DE, Ang A, Krousel-Wood M, Ward H. Predictive Validity of a
Medication Adherence Measure for Hypertension Control. Journal of Clinical
Hyperlension 2008; 10(5):348-354.
https://www.researchgate.net/publication/262580640_From_morisky_to_Hill-Bone_self-reports_scales_for_measuring_adherence_to_medication
Should be Empty:

Administer and score questionnaire