Development and validation of a treatment compliance assessment scale for clients with mental illnesses

Background: Treatment compliance improves mental health and facilitates the resolution of the underlying illness. An accurate assessment of treatment compliance is necessary for effective and efficient treatment planning and for ensuring that changes in health outcomes can be attributed to the recommended regimen. Aim: This study aimed to develop a treatment compliance assessment scale for clients with mental illnesses and to evaluate its psychometric properties. Methodology: The initial questionnaire was developed through the Delphi expert consultation, pilot study, and semistructured interview. The instrument was applied to 130 clients attending the outpatient services of a tertiary care hospital in North India. Results: A seven-item clinician-rated questionnaire was formed in which exploratory factor analyses yielded two factors, including medication compliance and attitude toward current treatment. The instrument was found to have a good internal consistency (Chronbach's alpha was 0.932), split-half reliability (Guttman's split-half coefficient - 0.838), and test-retest reliability (0.882). The concurrent validity of demonstrated a significant correlation with the 12-item Medication Adherence Rating Scale at P = 0.01. Conclusion: The clinician-rated treatment compliance assessment scale was found to be a valid instrument for assessing treatment compliance among patients with mental illnesses with adequate psychometric properties.