Development of Collaborative Medication Adherence in Bipolar disorder Questionnaire (C-MABQ)

Purpose: To develop a theory and evidence-based medication adherence questionnaire to identify an individual's modifiable determinants (barriers/facilitators) of adhering to medication for bipolar disorder (BD).Method: The questionnaire was developed by generating initial items based on a systematic review of adherence determinants in BD, followed by qualitative work to prioritise them and review by behavioural scientists.The resulting draft Collaborative Medication Adherence in Bipolar disorder Questionnaire.C-MABQv1, was reviewed by healthcare professionals for comprehensiveness and face validity.Their feedback was integrated into a second version, C-MABQv2, which was further refined through cognitive interviews with patients, leading to the final version of C-MABQ.Patients 18 or over diagnosed with BD and prescribed at least one BD medication participated in cognitive interviews.Results: Informed by our previous research, we initially formulated 75 items.These were reduced to 51 items (C-MABQv1) following discussion with behavioural science experts.Six healthcare professionals (two psychiatrists, two mental health pharmacists prescribers, two psychiatric nurse prescribers) participated in reviewing C-MABQv1.Similarly, seven patients with BD participated in cognitive interviews of C-MABQv2.The final C-MABQ demonstrated good readability (Flesch-Kincaid score = 66) and face and content validity, supporting its potential to assess individuals' prominent adherence determinants in BD.Conclusion: Grounded in theory and evidence, the C-MABQ is a clear, comprehensive and accessible questionnaire designed for people with BD to identify their key determinants of medication nonadherence.Thus, the C-MABQ facilitates personalised interventions by targeting those adherence determinants, offering strong potential to improve outcomes in BD.