Simplified Medication Adherence Questionnaire (SMAQ) for People Living With HIV in a National Hospital in Mexico: Instrument Validation Study
Bibliographic record
Abstract
BACKGROUND: Adherence to antiretroviral therapy is a critical component in achieving viral suppression in people living with HIV in addition to increasing overall quality of life. Several indirect methods have been used to measure adherence including the Simplified Medication Adherence Questionnaire (SMAQ). OBJECTIVE: The objective of this study is to evaluate the reliability and validity of the SMAQ in men living with HIV/AIDS attending a Mexican national hospital. METHODS: A cross-sectional analytical design study was carried out in a Mexican National Hospital in Jalisco, including men aged >18 years with at least 3 months of antiretroviral treatment, excluding those with cognitive difficulties in answering the survey. A minimum sample size was calculated to detect the contribution of the variables within the model. The analysis included descriptive tests, confirmatory factor analysis, reliability and validity assessment, correlation between adherence and viral load, and association between viral load and adherence. RESULTS: The final analysis included a total of 260 patients with a mean age of 43 (SD 12) years and an average of 8.97 (SD 6.33) years on antiretroviral treatment. The SMAQ showed sufficient structural validity (comparative fit index=1, root-mean-square error of approximation=0, 90% CI 0-0.085) with satisfactory factor loadings on most questions except item 2 (Do you always take your medication at the prescribed time?). The reliability of the scale is acceptable (Cronbach α=0.702, ω=0.718). Adherence correlated with viral load significantly but not with recent TCD4 lymphocyte levels. Patients classified as adherent were three times more likely to be undetectable than nonadherent patients (odds ratio 3.31, 95% CI 1.13-9.64, P=.04). CONCLUSIONS: The SMAQ represents an adequate tool to assess adherence in men living with HIV in the Mexican context, this will contribute to this study and compression of adherence to establish future intervention programs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".