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2025-11-13
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Copyright (c) 2025 Yandi Zhang, Boon Seng Tan, Huichao Liu, Nahlah Elkudssiah Ismail

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How to Cite
Translation and validation of the MUSE questionnaire in Chinese for elderly hypertensive patients: A study in the context of community pharmacist-led multidimensional educational interventions
Yandi Zhang
Faculty of Pharmacy, AIMST University, Bedong, 08100, Malaysia
Boon Seng Tan
Faculty of Pharmacy, Quest International University (QIU), Ipoh, 30250, Malaysia
Huichao Liu
Deputy Director Pharmacist, Department of Clinical Pharmacy, Pingdingshan First People's Hospital
Nahlah Elkudssiah Ismail
Faculty of Pharmacy, AIMST University, Bedong, 08100, Malaysia
DOI: https://doi.org/10.59429/esp.v10i11.4143
Keywords: community pharmacist; multidimensional educational intervention; elderly hypertension; medication self-efficacy; environmental adaptability; MUSE scale
Abstract
Objective: To translate, culturally adapt, and validate the Medication Understanding and Use Self-Efficacy (MUSE) Scale for Chinese elderly hypertensive patients (MUSE-CH), providing a psychometrically sound instrument to assess medication self-efficacy in the context of community pharmacist-led interventions. Methods: A two-phase mixed-methods approach was employed. Phase A involved establishing MUSE-CH through standardized forward-backward translation procedures. Five experts conducted content validity assessment, while reliability and construct validity were examined using Cronbach's α coefficients and Rasch modeling. Results: MUSE-CH demonstrated robust psychometric properties with S-CVI/Ave of 0.975 and total scale Cronbach's α of 0.847. Medication adherence behavior and medication learning dimensions showed α coefficients of 0.825 and 0.798, respectively. Conclusions: The MUSE-CH scale exhibits satisfactory reliability and validity for assessing medication self-efficacy in Chinese elderly hypertensive populations.
References
[1]. 1.Nicolucci A, Greenfield S, Mattke S. Selecting indicators for the quality of diabetes care at the health systems level in OECD countries. Int J Qual Health Care. 2006;18(1):26-30.
[2]. 2.Davis TC, Wolf MS, Bass 3rd PF, Thompson JA, Tilson HH, Neuberger M, et al. Literacy and misunderstanding prescription drug labels. Ann Intern Med. 2006;145:887–94.
[3]. 3.Fu HS, Yu BL, Han FF. Effect analysis of clinical pharmacists on medication management in community elderly hypertensive patients[J]. Medicine Forum, 2023, 44(13): 47-50.
[4]. 4.Guo CN. The influence of pharmacist participation in family medication guidance on community elderly hypertensive patients[J]. Chinese Practical Journal of Rural Doctor, 2022, 29(04): 22-24.
[5]. 5.Cameron KA, Ross EL, Clayman ML, Bergeron AR, Federman AD, Bailey SC, Davis TC, Wolf MS. Measuring patients' self-efficacy in understanding and using prescription medication. Patient Education and Counseling. 2010;80(3):372–376.
[6]. 6.Al Abboud SA, Ahmad S, Long Bidin MB, Ismail NE. Validation of Malaysian versions of Perceived Diabetes Self-Management Scale (PDSMS), Medication Understanding and Use Self-Efficacy Scale (MUSE) and 8-Morisky Medication Adherence Scale (MMAS-8) using Partial Credit Rasch Model. Malays J Pharm Sci. 2020;18(2):1–14.
[7]. 7.Sha W, Ning L, Li H, et al. The Effects of Health Education and the Sunrise Model of Nursing Care on Blood Pressure Control and Psychological Status in Elderly Patients with Hypertension[J]. Alternative Therapies in Health and Medicine, 2025, 31(1): 288-293.
[8]. 8.Senoo K, Nakata M, Yukawa A, et al. Relationship between screening-detected atrial fibrillation and blood pressure levels in elderly hypertensive patients: The OMRON Heart Study[J]. Thrombosis and Haemostasis, 2024, 125(6): 545-552.
[9]. 9.Zhou JW, Wu JH, Chen MX. Effect analysis of primary clinical pharmacists implementing rational drug use education for community elderly hypertensive patients[J]. North Pharmacy, 2021, 18(07): 138+180.
[10]. 10.Li X, Li J. Predictive value of lipid levels in coronary heart disease in elderly hypertensive patients[J]. American Journal of Translational Research, 2025, 17(4): 2754-2763.
[11]. 11.Gu LL, Yang X. Study on the current status of rational drug use in elderly hypertensive patients with diabetes from the perspective of community clinical pharmacists[J]. Shanxi Medical Journal, 2021, 50(05): 706-709.
[12]. 12.He YY, Chen L, Gao H, et al. Application of picture-based conversational health education in medication safety for community elderly hypertensive patients[J]. Journal of Nursing Science, 2025, 40(04): 86-91.
[13]. 13.Liu H, Zheng XH, Cui HD. Impact of family pharmacist participation in family doctor contracted binding service model on community elderly hypertensive patients[J]. Medicine Frontier, 2025, 15(15): 134-137.
[14]. 14.Ni L, Xie H. Discussion on the impact of pharmacist intervention on therapeutic efficacy and medication adherence in community outpatient elderly hypertensive patients[J]. Chinese Medicine and Pharmacy, 2017, 7(12): 235-237.
[15]. 15.Song S, Cai X, Hu J, et al. Serum Uric Acid and Bone Health in Middle-Aged and Elderly Hypertensive Patients: A Potential U-Shaped Association and Implications for Future Fracture Risk[J]. Metabolites, 2025, 15(1): 15-15.
[16]. 16.Liu H, Zuo X, Zhou Z, et al. Antihypertensive Medication Adherence and Related Factors among Elderly Hypertensive Patients in China: A Meta-analysis[J]. Indian Journal of Public Health, 2025, 69(1): 82-90.
[17]. 17.Sun R, Zhou LL, Zhang YF, et al. Interventional study on medication therapy management in elderly hypertensive patients based on family pharmacist intelligent services[J]. Evaluation and Analysis of Drug-use in Hospitals of China, 2025, 25(06): 675-678+686.
[18]. 18.Zhang T. Analysis of application effect of pharmacist intervention in elderly hypertensive patient management[J]. Chinese Community Doctors, 2024, 40(35): 11-13.
[19]. 19.Jiang HJ. Application effect of clinical pharmacist-led remote chronic disease pharmaceutical services in elderly hypertensive patients[J]. Sino-Foreign Medical Research, 2024, 3(22): 3-5.
[20]. 20.Zhang YD, Zhang QY, An WD, et al. A randomised trial comparing usual versus strict home blood pressure control in elderly patients with hypertension: protocol and initial progress[J]. Blood Pressure, 2025, 11-16.
[21]. 21.Fahruddin K, Sekar MP, Tantut S. The relationship between self-care management with quality of life at elderly with hypertension in nursing home of Jember[J]. Working with Older People, 2025, 29(1): 48-56.
[22]. 22.Fu CZ, Zheng J, Xu LP. Observation on intervention effect of clinical pharmacist-led remote chronic disease pharmaceutical services on elderly hypertensive patients[J]. Chinese Rural Medicine, 2024, 31(10): 21-23.
[23]. 23.Gao YL, Zhou MH, Ou HY. Pharmacoeconomic evaluation of family pharmacist service model in managing elderly hypertensive patients[J]. Chinese Pharmacoeconomics, 2024, 19(04): 24-28.
[24]. 24.Jin X, Wei Y, Mo Y, et al. Associations of obesity and novel lipid indicators in the risk of type 2 diabetes mellitus in Chinese elderly hypertensive patients[J]. Frontiers in Endocrinology, 2025, 16: 1475323-1475323.
[25]. 25.Lin R, Zou P, Luo H, et al. Factors influencing dietary behavior among elderly patients with hypertension in Wenzhou, China: A qualitative descriptive study[J]. Healthcare and Rehabilitation, 2025, 1(2): 100026-100026.
[26]. 26.Qiu XJ, Chen Y, Feng WC. Impact of pharmaceutical service intervention on treatment and medication safety in elderly hypertensive patients[J]. Guangzhou Medical Journal, 2023, 54(12): 49-54.
[27]. 27.Wang ZM, Tian DM. Impact of pharmaceutical service intervention on health, treatment compliance in elderly hypertensive patients and medication safety analysis[J]. International Journal of Geriatrics, 2023, 44(04): 424-428.
[28]. 28.Zhu WS, Ba WQ. Impact of pharmacist intervention on medication efficacy in elderly hypertensive patients[J]. Clinical Rational Drug Use, 2023, 16(12): 154-157.
[29]. 29.Le Y. Application effect of pharmaceutical service intervention based on medication therapy management in elderly hypertensive patient management[J]. Electronic Journal of Integrated Traditional Chinese and Western Medicine Cardiovascular Disease, 2023, 11(08): 27-29+20.
[30]. 30.Ge X, Yao L, Liu Y, et al. Comparing machine learning models for predicting preoperative DVT incidence in elderly hypertensive patients with hip fractures: a retrospective analysis[J]. Scientific Reports, 2025, 15(1): 13206-13206.
[31]. 31.Yaqian H. Ambulatory Blood Pressure Characteristics and Risk Factors for Circadian Rhythm Abnormalities in Elderly Patients with Hypertension[J]. Journal of Clinical and Nursing Research, 2025, 9(3): 154-160.
[32]. 32.Fan YT, Ni J. Study on the efficacy of clinical pharmacist pharmaceutical services on blood pressure control in elderly inpatient hypertensive patients[J]. Medicine Forum, 2023, 44(04): 48-51.
[33]. 33.Jiang H, Liu CC, Wang MC, et al. Impact of remote chronic disease pharmaceutical services on blood pressure control and treatment compliance in elderly hypertensive patients[J]. Hebei Medical Journal, 2022, 44(24): 3782-3784.
[34]. 34.Yang H, Hu J, Deng T, et al. Impact of health management on medication adherence and blood pressure and blood glucose indices in elderly patients with hypertension and diabetes mellitus[J]. Endocrine, 2025, 89(2): 1-8.
[35]. 35.Alinejad N, Khosromanesh F, Bijani M, et al. Spiritual well-being, resilience, and health-promoting lifestyle among older adult hypertensive patients: a cross-sectional study[J]. BMC Geriatrics, 2025, 25(1): 265-265.
[36]. 36.Ma Y, Feng P, Zhu SG. Impact of clinical pharmacist-led chronic disease management on treatment outcomes in elderly hypertensive patients[J]. Clinical Rational Drug Use, 2022, 15(32): 11-14.
[37]. 37.Han S, Wu DW, Bai Y, et al. Multi-center randomized controlled trial of pharmacist-led chronic disease management on blood pressure in discharged elderly hypertensive patients[J]. Clinical Journal of Drug Therapy, 2022, 20(05): 38-42.
[38]. 38.Huang XW, Hong SS, Chen TT, et al. Impact of pharmacist intervention on medication adherence and efficacy in elderly hypertensive discharge patients[J]. Strait Pharmaceutical Journal, 2022, 34(05): 98-101.
[39]. 39.Guo CN. The influence of pharmacist participation in family medication guidance on community elderly hypertensive patients[J]. Chinese Practical Journal of Rural Doctor, 2022, 29(04): 22-24.
[40]. 40.Romero GMJ, Guzmán NDD, Arreola OF, et al. Chronic DeBakey Type IIIB Aortic Dissection Presenting Acutely: A Diagnostic and Surgical Challenge in an Elderly Hypertensive Patient[J]. Cureus, 2025, 17(6): e85310-e85310.
[41]. 41.Li Y, Chen SQ, Shen M, et al. Analysis of medication status in community empty-nest and non-empty-nest elderly hypertensive patients[J]. Journal of Pharmaceutical Practice, 2022, 40(02): 184-187.
[42]. 42.Shen H. Study on the impact of pharmacist intervention on medication adherence in elderly hypertensive patients[J]. World Latest Medicine Information, 2017, 17(14): 119.
[43]. 43.Xu L, Hu W, Yao CF. Effect analysis of pharmaceutical service intervention on community elderly hypertensive patients[J]. Medicine Frontier, 2021, 11(17): 187-189.
[44]. 44.Shi NN, Zhen JC, Liang JH, et al. Practice and effect evaluation of remote chronic disease pharmaceutical services for elderly hypertensive patients[J]. Chinese Journal of Hospital Pharmacy, 2021, 41(10): 1069-1074+1084.
[45]. 45.Xu L, Liu R. The Impact of Comprehensive Nursing Based on Protection Motivation Theory on Treatment Compliance and Quality of Life in Elderly Patients with Hypertension[J]. Journal of Clinical and Nursing Research, 2025, 9(6): 378-384.
[46]. 46.Mei L, Zhou HF, Ma C, et al. Analysis of intervention effects of service model based on medication therapy management on community elderly hypertensive patients[J]. Evaluation and Analysis of Drug-use in Hospitals of China, 2021, 21(01): 97-100.
[47]. 47.Wang CT, Gao Y. Study on the impact of medication guidance on improving medication safety in elderly hypertensive patients[J]. Chinese Rural Health, 2021, 13(01): 52-53.
[48]. 48.Wu L, Wang ZS, Xie L. Effect evaluation of pharmacist participation in chronic disease management for elderly hypertensive outpatients[J]. Pharmacy and Clinical Research, 2020, 28(06): 478-480.
[49]. 49.Zou QW, Zheng GM, Wang ZX, et al. Discussion on pharmaceutical intervention model of pharmacists for elderly patients with contracted family doctors[J]. Chinese Journal of Rational Drug Use, 2020, 17(09): 25-28.
[50]. 50.Zhang RL. Study on the effect of pharmaceutical services in improving medication adherence and efficacy in elderly hypertensive patients[J]. World Journal of Complex Medicine, 2020, 6(07): 1-3.
[51]. 51.Peng L, Yang YL, Han S, et al. Analysis of factors affecting medication adherence in elderly hypertensive patients[J]. Clinical Journal of Drug Therapy, 2019, 17(11): 57-61.
[52]. 52.Li Z, Li X, Yin W, et al. The relationship between illness perception and quality of life among Chinese rural elderly patients with hypertension: the mediating role of medication experience[J]. BMC Geriatrics, 2025, 25(1): 523-523.
[53]. 53.Hu PF. Application and impact analysis of pharmaceutical services for community elderly hypertensive patients[J]. Journal of Practical Medical Techniques, 2019, 26(04): 504-505.
[54]. 54.Wu S, Li WQ. Impact of pharmaceutical service intervention on blood pressure levels and medication adherence in elderly hypertensive patients[J]. China Practical Medicine, 2019, 14(31): 129-130.
[55]. 55.Bai Y, Wang JW, Zhou Z. Impact of clinical pharmacist-led management model on treatment outcomes in elderly hypertensive patients[J]. Chinese Medicine, 2019, 14(04): 509-512.
[56]. 56.Wu DW, Han S, Shi NN, et al. Role of clinical pharmacist-led chronic disease management in improving medication understanding among elderly hypertensive patients[J]. China Pharmacy, 2018, 29(23): 3251-3254.
[57]. 57.Zhang H, Zhang Z, Zhu J, et al. Bridging gaps in risk factor control and adherence to recommended lifestyle among Non-Elderly hypertensive patients[J]. Scientific Reports, 2025, 15(1): 29204-29204.
[58]. 58.Zhang W, Wu DW, Shi NN, et al. Exploration and practice of remote pharmaceutical service model in follow-up of elderly hypertensive patients[J]. Clinical Journal of Drug Therapy, 2018, 16(06): 66-68.
[59]. 59.Jin CC. Role of pharmacist intervention in improving medication adherence in elderly hypertensive patients[J]. Journal of Traditional Chinese Medicine Administration, 2017, 25(20): 83-85.
[60]. 60.Qin WH. Analysis of the impact of medication guidance on medication safety in elderly hypertensive patients[J]. Chinese Rural Health, 2017, (06): 50.
[61]. 61.Zhou CX, Dai Y, Chen C, et al. Study on the effect of pharmaceutical services in improving medication adherence and efficacy in elderly hypertensive patients[J]. China Pharmaceuticals, 2017, 26(06): 88-91.






