{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:56Z","timestamp":1792787276510,"version":"4.5.0"},"reference-count":127,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia (FCT), Portugal","award":["PRT\/BD\/154774\/2022https:\/\/doi.org\/10.54499\/PRT\/BD\/"],"award-info":[{"award-number":["PRT\/BD\/154774\/2022https:\/\/doi.org\/10.54499\/PRT\/BD\/"]}],"id":[{"id":"https:\/\/ror.org\/00snfqn58","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,25]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To map medication adherence assessment tools used among African populations with chronic diseases and describe their methodological characteristics, validation status, cultural adaptation, administration methods and reported adherence rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>PubMed, Scopus and Web of Science were searched on 25 June 2026.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria<\/jats:title>\n                    <jats:p>Studies conducted in African countries that assessed medication adherence among individuals with chronic diseases using any adherence measurement tool were eligible. Studies focusing exclusively on acute conditions, non-medication adherence behaviours, reviews, editorials, protocols and conference abstracts were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction<\/jats:title>\n                    <jats:p>Data were extracted using a standardised charting form and summarised descriptively. Information on study characteristics, adherence measurement tools, validation and cultural adaptation procedures, administration methods, disease-specific applicability, supplementary adherence assessment methods, and reported adherence rates was synthesised narratively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>98 studies conducted across 27 African countries were included. Ethiopia (n=36) and Nigeria (n=22) contributed the largest number of studies. Type 2 diabetes (n=29), hypertension (n=18) and HIV (n=13) were the most frequently investigated conditions. The 8-item Morisky Medication Adherence Scale was the most used instrument, appearing in 50 studies. Only 15 studies (15.3%) reported local validation and\/or cultural adaptation of adherence instruments. Most studies relied on generic self-report measures administered by interviewers, while relatively few incorporated supplementary methods such as pharmacy refill records, pill counts, electronic monitoring, viral load assessment or biological markers. Reported medication adherence rates varied substantially across diseases, ranging from 0% to 96.8%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Medication adherence assessment in Africa is characterised by considerable methodological variability and limited evidence of local validation and cultural adaptation. The widespread use of generic self-report instruments and the scarcity of objective adherence measures highlight the need for greater standardisation and context-specific validation of adherence assessment tools across diverse African healthcare settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-112898","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:55:11Z","timestamp":1789570511000},"page":"e112898","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mapping medication adherence tools in Africa: a scoping review"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4507-6506","authenticated-orcid":false,"given":"Izaidino Jaime","family":"Muchanga","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Center for Health Technologies and Services Research, University of Porto, Porto, Portugal"},{"name":"Xai-Xai Extension, Saint Thomas University of Mozambique, Xai-Xai, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00eds","family":"Mid\u00e3o","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avelino","family":"Mazuze","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Center for Health Technologies and Services Research, University of Porto, Porto, Portugal"},{"name":"Faculty of Health Sciences, L\u00fario University, Nampula, Mozambique"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Melo","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leovaldo","family":"Alc\u00e2ntara","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisio","family":"Costa","sequence":"additional","affiliation":[{"name":"RISE-Health, Competence Centre for Active and Healthy Ageing, Faculty of Pharmacy, University of Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Sousa-Pinto","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal"},{"name":"Center for Health Technologies and Services Research, University of Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"2026091607550469000_16.9.e112898.1","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1007\/s12325-025-03105-x","article-title":"Are Treatment Adherence Factors Apparent in Patients with Asthma and to Physicians? 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