Adherence to Refills and Medications Scale (ARMS)


Questionnaire to assess self-reported adherence to medication for patients of all literacy levels.

Key Benefits

  • Increases patient adherence to medication prescription.
  • ARMS-D (diabetes-specific) identifies barriers to adherence.

Market Summary

Taking medication on time is crucial for the successful management of chronic illness, but only 50%-70% of patients adhere to the medications they are prescribed. Illiteracy increases the difficulty of adherence to medications, as illiterate patients are less likely to identify their medications, drug indications and side effects. In order to more accurately assess a patient’s adherence to medication and formulate a method of intervention to improve adherence, providers need an accurate method of measuring adherence.

Technical Summary

Emory researchers have developed the Adherence to Refills and Medications Scale (ARMS), a novel medication adherence scale, and demonstrated its validity and consistency among patients across literacy levels. The ARMS consists of 14 questions administered verbally by healthcare professionals. The scale has been validated against the Morisky adherence scale, as well as refill adherence and clinical outcomes such as blood pressure. In addition, the ARMS was able to accurately measure adherence even among low-literacy patients. Emory researchers have further optimized ARMS for assessment of type-2 diabetic patients (ARMS-D). In a study, the ARMS-D was shown to be a reliable and valid measure of diabetes medication adherence and more predictive of HbA1C than the SDSCA-MS, although it takes more time to administer. The ARMS-D also identifies barriers to adherence, which may be useful in research and clinical practice. These tools may be used to improve prescription drug adherence across a large patient population.

Developmental Stage

  • ARMS was developed, pilot tested, and administered to 435 patients with coronary heart disease in an inner-city primary care clinic.
  • Administered self-report measures in study for ARMS-D to 314 adult outpatients prescribed medications for type 2 diabetes and collected point-of-care HbA1C.
  • Currently available in the following languages: English, French, German, Greek, Italian, Portuguese (Brazil), Portuguese (Portugal), Spanish (Latin America), Spanish (Spain), Chinese (China), and Chinese (Taiwan).


Kripalani, S. et al. (2009). Value in Health, 12(1), 118-123.
Mayberry, L.S. et al. (2013). Diabetes Res Clin Pract, 102(2), 96-104.

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Patent Information

Tech ID: 18080
Published: 1/23/2019