Rating of Medication Influences (ROMI) Scale in Schizophrenia

Abstract

Noncompliance with neuroleptic treatment is a major barrier to delivery of effective treatment for schizophrenia outpatients. This article describes the development of a standardized measure for the assessment of attitudinal and behavioral factors influencing patient compliance with neuroleptic treatment. The Rating of Medication Influences (ROMI) scale was developed as part of a longitudinal study of neuroleptic noncompliance in schizophrenia and administered to 115 discharged schizophrenia outpatients. Analyses of the following were conducted to assess the scale's psychometric properties: (1) interrater reliability, (2) internal consistency, (3) principal components, (4) correlation with other subjective measures, and (5) correlation with independent family reports. Most (95%) of the ROMI patient-report items were reliable, whereas rater-judgment items were not reliable. The rater section was dropped. A principal components analysis of the reliable patient-report items yielded three subscales related to compliance (Prevention, Influence of Others, and Medication Affinity) and five subscales related to noncompliance (Denial/Dysphoria, Logistical Problems, Rejection of Label, Family Influence, and Negative Therapeutic Alliance). There were significant correlations between these subscales, and independently obtained family-report ROMI items were significant. The Denial/Dysphoria subscale correlated strongly with two other published measures of dysphoric response to neuroleptics, whereas the other noncompliance subscales did not. The ROMI is a reliable and valid instrument that can be used to assess the patient's subjective reasons for medication compliance and non-compliance. The subscale findings suggest that the ROMI provides a more comprehensive data base for patient-reported compliance attitudes than the other available subjective measures. Indications for use of the ROMI and other subjective measures of neuroleptic response are reviewed.

Drug attitude as predictor for effectiveness in first-episode schizophrenia: Results of an open randomized trial (EUFEST)

“…Several scales have been developed for an easy and valid assessment of such attitudes (e.g. Hogan et al 1983, McEvoy et al 1989, Weiden et al 1994, Kampman et al 2000, Dolder et al 2004). The Drug Attitude Inventory (DAI) by Hogan, Awad and colleagues (1983) is one of the earliest developed and most widely used scale.…”

Cross-cultural adaptation to Brazil of Medication Adherence Rating Scale for psychiatric patients

“…For this search we used the following keywords: adesão, aderência, escala, psiquiatria, compliance, adherence, medication, scale and psychiatric. We found seven medication adherence rating scales: Drug Attitude Inventory (DAI) 13 , Rating Of Medication Influences (ROMI) 14 , Medida de Adesão aos Tratamentos (MAT) 15 , Medication Adherence Rating Scale (MARS) 16 , Attitudes towards Neuroleptic Treatment (ANT) 17 , Brief Evaluation of Medication Influences and Beliefs (BEMIB) 18 , and Brief Adherence Rating Scale (BARS) 19 . Most of these scales found in the literature have some limitations regarding its use with psychiatric patients in Brazil.…”

Reliability and Validity of the Japanese Version of BEMIB Modified for Patients With Bipolar Disorder: a Self-rating Scale for Medication Adherence

“…Moreover, only a few drugs can be readily measured at clinical sites. Physician use of a structured interview that includes an evaluation scale, the Rating of Medication Influence (ROMI), has been reported [14]; however, this rating instrument is not used in routine clinical practice because of the training required for the person performing the interview, and because of the total amount of time needed to complete the interview. In a study in which the adherence of schizophrenic outpatients was evaluated by various methods, the proportion of patients considered nonadherent was 3% in self-reports, but 24% and 25% in physician evaluation and pill counting, respectively, and 52% in an evaluation method in which an electronic device, the Electronic Medication Monitor (EMM), was used.…”