Phase three: Pilot testing
Fifty-five participants with asthma were recruited; they confirmed that every item was clear and comprehensible. The questionnaire needed from one to three minutes to be completed, within an average of two minutes.
Each item in the AAMQ-13 has five possible scores ((1) always, (2) often, (3) sometimes, (4) rarely, and (5) never; where (1) represents the worst possible score and (5) represents the best possible score). These response options were based on the consensus reach by the expert panel. The AAMQ-13 has a score range from 13 to 65. The final scores were divided into three categories of adherence: poor adherence (score= 13-29), moderate adherence (score= 30-47), and excellent adherence (score= 48-65). It is important to mention that we take into consideration that some patients with asthma do not use inhalers, and as a consequence we decided to reduce the 13 items into 10 items for these patients (AAMQ-10). Thus, to assess adherence, in case of non-inhaler using patients with asthma, the first 10 items need to be answered found in the Supplemental Material. In this scenario, the 10-items AAMQ will have a total possible score of 50. To assist analysis, scores were arbitrarily divided into three categories indicating: poor adherence (score ≤ 22), moderate adherence (score= 23-36), and excellent adherence (score= 37-50).