Transculturally adaptation and validation of the basel assessment of adherence to immunosuppressive medication scale (baasis©) interview questionnaire among turkish kidney transplant recipients

Abstract

Objective: Kidney transplantation provides better survival and quality of life. Non-adherence to immunosuppressive treatment is a prognostic indicator for poor long-term post-transplantation outcomes. Questionnaires are one of the instruments for adherence evaluation. We aimed to transculturally adapt and validate the Basel Assessment of Adherence to Immunosuppressive Medication Scale Interview Questionnaire among Turkish kidney recipients.Methods: The Basel Assessment of Adherence to Immunosuppressive Medication Scale Interview Questionnaire was applied to 125 recipients. The questionnaire consisted of 5 questions (Q) and a 10 cm Visual analogue scale assessing overall medication adherence over the last 4 weeks except Q4. Q4 assessed adherence over the last year. Guillemin protocol was used for translation and transcultural adaptation. Psychometric tests were performed for reliability (kappa coefficient and Cronbach's alpha) and validation (content and construct validities).Results: A total of 125 adult kidney recipients, followed for at least 1 year after transplantation were included. The mean following time was 63.9 +/- 44.8 months. The mean serum creatinine level was 1.45 +/- 0.77 mg/dL and the eGFR value was 60.3 +/- 24.4 mL/min/1.73 m(2). The participants were on tacrolimus- (60.5%), cyclosporine- (26.6%), and everolimus-based (12.9%) immunosuppressive regimen. There was no disagreement about the processes including translation in Turkish, and re-translation to English between the researchers. The transculturally adapted questionnaire has a kappa coefficient of 0.915 which indicates excellent reliability, and a Cronbach's alpha coefficient of 0.454 which indicates acceptable internal consistency. For construct validity, factorial loads were 0.756, 0.779, 0.829, 0.393, and 0.032 for questions 1a, 1b, 2, 3, and 4, respectively.Conclusion: We conclude that the validated Turkish version of the BAASIS (c) Interview Questionnaire with satisfactory psychometric tests can contribute a practical approach to determine immunosuppressive treatment adherence in Turkish kidney recipients.