@article{article,
  keywords = {morbidity management and disability prevention, MMDP, Morbidity management, Disability prevention,  filarial lymphedema, Adherence},
  author = {Ramar G and Sadhasivam A and Gnanasekaran V and Periyathambi M and Balakrishnan V and Kuttiatt V},
  title = {Developing a scoring tool for assessing adherence to morbidity management and disability prevention (MMDP) practices in patients with filarial lymphedema: A pilot study.},
  abstract = {<p><strong>BACKGROUND:</strong></p>

<p>Morbidity Management and Disability Prevention (MMDP) practices are essential in mitigating the progression of lymphedema and in preventing episodes of adenolymphangitis. Despite their importance, patients{\textquoteright} adherence to these prescribed practices has frequently been found to be suboptimal. Currently, there is a lack of a standardized tool for the objective assessment of patients{\textquoteright} adherence to MMDP practices in patients with filarial lymphedema. This study was undertaken to develop a scoring system for assessing patients{\textquoteright} adherence to MMDP and to validate this among patients attending a filariasis management clinic.</p>

<p><strong>METHODOLOGY: </strong></p>

<p>A scoring tool (VCRC MMDP Adherence Assessment Tool and VAAT score) was developed to evaluate adherence to MMDP practices across eight defined domains. The total score ranges from 0 to 40, reflecting the degree of adherence. This tool was validated through a cross-sectional study involving 90 patients diagnosed with varying grades of filarial lymphedema.</p>

<p><strong>RESULTS: </strong></p>

<p>Based on the VAAT score, patients were categorizable into three different levels of adherence: optimal adherence (>= 30), medium adherence (20-29) and poor adherence (\&lt; 20). Among the 90 patients assessed, 21 (23\%) demonstrated optimal adherence, 47 (52\%) showed medium adherence and 22 (25\%) were categorized as having poor adherence.</p>

<p><strong>CONCLUSION: </strong></p>

<p>This study marks the first development and validation of a scoring system to assess adherence to MMDP practices in patients with filarial lymphedema. The tool proved useful in effectively identifying individuals with suboptimal adherence. However, further validation is required in a greater number of patients in a prospective manner and in different geographical and epidemiological settings.</p>
},
  year = {2026},
  journal = {PloS one},
  volume = {21},
  pages = {1 - 8},
  month = {09/2026},
  issn = {1932-6203},
  url = {https://pmc.ncbi.nlm.nih.gov/articles/PMC13626310/pdf/pone.0358191.pdf},
  doi = {10.1371/journal.pone.0358191},
  language = {ENG},
}