---
title: "Medication adherence tools in Africa: scoping review of methods, validation, and reported rates"
id: "bmj-open-0-mapping-medication-adherence-tools-in-africa-a-scoping-review"
canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-0-mapping-medication-adherence-tools-in-africa-a-scoping-review"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "BMJ Open"
source_url: "http://bmjopen.bmj.com/cgi/content/short/16/9/e112898?rss=1"
published_at: "2026-09-16T13:30:50.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Medication adherence tools in Africa: scoping review of methods, validation, and reported rates
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-0-mapping-medication-adherence-tools-in-africa-a-scoping-review
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** BMJ Open
- **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/9/e112898?rss=1)
- **Published At:** 2026-09-16T13:30:50.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- This scoping review mapped tools used to assess **medication adherence** among people with chronic diseases across African countries, following PRISMA-ScR methods. - Literature searches of PubMed, Scopus and Web of Science were completed on 25 June 2026. - Ninety-eight studies from 27 African countries were included; Ethiopia (n=36) and Nigeria (n=22) contributed the most studies. - The most commonly studied conditions were **type 2 diabetes** (n=29), **hypertension** (n=18) and **HIV** (n=13). - The **8-item Morisky Medication Adherence Scale** was the single most used instrument, employed in 50 studies. - Only 15 studies (15.3%) reported local validation and/or cultural adaptation of adherence instruments. - Most studies used generic self-report measures administered by interviewers; objective or supplementary methods (pharmacy refill, pill counts, electronic monitoring, viral load, biological markers) were relatively uncommon. - Reported adherence rates varied widely across studies and diseases, from 0% to 96.8%. - Overall findings indicate substantial methodological variability, limited context-specific validation, and an overreliance on interviewer-administered self-report tools, highlighting the need for standardisation and local adaptation of adherence assessment in African settings.
## Clinical Analysis & Structured Key Points
Objectives 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. Design Scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Data sources PubMed, Scopus and Web of Science were searched on 25 June 2026. Eligibility criteria 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. Data extraction 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. Results 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%. Conclusions 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.
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