THE MORISKY MEDICATION ADHERENCE SCALE 4 ITEM

MMAS® – MORISKY MEDICATION ADHERENCE SCALE
Effective Date: 2025

This End-User License Agreement (EULA) is a legal agreement between the user (“Licensee”) and MMAR, LLC dba ADHERENCE (“Licensor”), the authorized owner of the Morisky Medication Adherence Scale (MMAS®) and all associated proprietary versions, translations, scoring algorithms, and derivative works.

By accessing, using, or incorporating the MMAS into any academic or research-related project, the Licensee agrees to be bound by the terms and conditions of this EULA.

                                                                                          1. Grant of License

The Licensor grants the Licensee a non-exclusive, non-transferable, limited license to use the MMAS exclusively for the purposes of academic research, clinical studies, and scholarly publication.

This license does not include the right to sublicense, adapt, modify, publicly distribute, or commercialize the MMAS in whole or in part without express written permission from the Licensor.

The MMAS may be used in academic settings including:

• Investigator-initiated clinical studies
   
• IRB-approved research protocols
   
• Educational publications, theses, or dissertations
   
• Peer-reviewed journals
   

The Licensee agrees to adhere to best practices for academic integrity while maintaining the confidentiality of the scoring system and complying with attribution and reporting obligations described below.

The Licensee acknowledges that the following names and marks are registered trademarks and the exclusive intellectual property of the Licensor:

• Morisky Medication Adherence Scale™
   
• MMAS™, MMAS-4™, MMAS-8™, MMAS-8R™
   
• ATLAS Platform™
   
• All translations and versions thereof
   

The Licensee is granted limited, non-commercial permission to reference these marks strictly in connection with properly licensed academic research.

Trademark Limitation: Licensee may not assign, sublicense, publish, or represent the MMAS trademarks as their own, or use the Licensor’s trademarks beyond what is expressly permitted under this EULA.
 

The Licensee shall not:

• Sell, rent, lease, sublicense, or redistribute the MMAS to any third party
   
• Reverse engineer, alter, modify, or create derivative works from the MMAS
   
• Translate the MMAS without prior written approval from the Licensor
   
• Publish or disclose the proprietary scoring algorithm or internal constructs
   
• Incorporate the MMAS into a digital application or ePRO system without an additional license agreement
   

The MMAS scoring algorithm is a proprietary trade secret and remains confidential. The Licensee agrees:

• Not to disclose, reverse-engineer, or publish the algorithm in any form
   
• To maintain reasonable measures to protect its confidentiality
   
• To refer to the scoring system only using approved descriptive language
   

Approved language for publication use:

“The MMAS-8 scale consists of 8 items. Each of the first 7 items has 2 possible responses (yes/no), while the 8th item is answered on a 5-point Likert scale. The total score ranges from 0 to 8. Higher scores reflect higher medication adherence. A score < 6 is considered low adherence, 6–7 is moderate adherence, and 8 indicates high adherence.”
 

As a condition of this license, the Licensee agrees to:

• Provide attribution in all publications using MMAS-derived data:
  ©MMAS 2006. Used with permission. www.adherence.cc
   
• Submit copies of any published work to the Licensor (preprint or final)
   
• Acknowledge the MMAS as a validated adherence measure developed by Donald E. Morisky, ScD, ScM, MSPH
   

The MMAS, its content, structure, translations, and scoring algorithms remain the sole property of the Licensor. No part of this EULA shall be construed as granting ownership, authorship, or proprietary rights to the Licensee.

This license is effective upon use and shall remain in force until terminated.

The Licensor may terminate the license if the Licensee:

• Breaches any provision of this EULA
   
• Uses the MMAS beyond the academic scope of this license
   
• Violates the trademark or confidentiality restrictions
   

Upon termination, the Licensee must cease all use of the MMAS and destroy any stored copies.

The MMAS is provided “as is”, without warranty of any kind, either express or implied. The Licensor is not liable for any damages arising from use of the MMAS in research, treatment, or clinical decision-making.

This EULA shall be governed by and interpreted under the laws of the State of California, without regard to conflict-of-law principles.

The Licensor reserves the right to amend this EULA at any time. Notice will be provided to registered Licensees or posted at www.adherence.cc. Continued use of the MMAS constitutes acceptance of any amended terms.

This EULA represents the entire agreement between the parties and supersedes all prior representations, understandings, or agreements related to the MMAS.

By using the MMAS, you acknowledge that you have read, understood, and agreed to the above terms.