MVMT™: Measurable Variance Minimal Term

MVMT™ ( Measurable Variance Minimal Term ) was developed to fill a critical gap in adherence measurement: the lack of a behaviorally anchored, time-specific instrument that captures a patient’s actual medication-taking behavior over a defined recent period. Existing scales often rely on present-tense, perception-based items, which can introduce recall bias, optimism bias, and psychometric inconsistencies. MVMT addresses these limitations by focusing on concrete behavior over the past week, providing a precise “snapshot” of adherence.

Where BASE™ measures predictive stability—the “video” of where a patient is heading—MVMT™ captures retrospective reality, the “still photograph” of what has already occurred. Together, these tools form a dual-lens system that grounds adherence assessment in both predictive modeling and lived behavioral evidence.

Behavioral science shows that past behavior is the best predictor of future behavior. To ensure validity, MVMT items are:

• Specific and time-anchored: All questions refer to the past seven days.
   
• Behaviorally observable: Avoid vague phrasing such as “sometimes” or “ever” to reduce psychometric noise.
   
• Domain-distinct: Each item measures a unique adherence domain, maximizing clarity and internal consistency.
   
• Intentional vs. unintentional: MVMT differentiates intentional lapses from those due to forgetfulness or logistical barriers, enabling tailored intervention.
   
• Paired with BASE™: Each MVMT item conceptually aligns with a BASE item to create a complementary system: BASE anticipates stability, MVMT verifies actual behavior.
   

This is not a test. There are no right or wrong answers. Everyone manages medications differently. These assessments are designed to understand patient experiences, identify patterns, and guide supportive care. Responses are confidential.

Scoring for each item:

• No = 1.0
   
• Yes, once = 0.5
   
• Yes, more than once = 0.0
   

Answer each question as honestly as possible, reflecting your recent experiences.

1. Routine — In the past 7 days, did you have trouble taking your medication at the same time each day?
   ☐ No ☐ Yes, once ☐ Yes, more than once
    
2. Memory — In the past 7 days, did you miss any doses?
   ☐ No ☐ Yes, once ☐ Yes, more than once
    
3. Symptom Response — In the past 7 days, did you skip or stop taking medication because you felt better?
   ☐ No ☐ Yes, once ☐ Yes, more than once
    
4. Side-Effects Response — In the past 7 days, did you stop or skip medication because of side effects?
   ☐ No ☐ Yes, once ☐ Yes, more than once
    
5. Environment — In the past 7 days, did travel or changes in your environment cause you to miss medication?
   ☐ No ☐ Yes, once ☐ Yes, more than once
    
6. Flexibility — In the past 7 days, did you have difficulty adjusting your routine to take medication when your schedule changed?
   ☐ No ☐ Yes, once ☐ Yes, more than once
    
7. Integration — In the past 7 days, did taking medication feel like a hassle or not fit naturally into daily life?
   ☐ No ☐ Yes, once ☐ Yes, more than once
    

Intentional Non-Adherence Items: Q3 (Symptom Response) and Q4 (Side-Effects Response)

MVMT_norm          Raw Score (0–7)          Descriptor                    Interpretation

0.00–0.25                  0–1.75                              Highly Prone              Adherence very limited

0.26–0.50                  2–3.5                                 Unstable                       Multiple lapses, inconsistent behavior

0.51–0.75                  3.5–5.25                         Moderately Steady Mostly adherent, occasional lapses

0.76–1.00                  5.25–7                             Reliable                          Strong adherence, few or no lapses 

MVMT provides a concrete behavioral snapshot, capturing real-time adherence and enabling the calculation of behavioral fragility metrics in conjunction with BASE and STRATA. By distinguishing between intentional and unintentional lapses, the instrument provides actionable insights for clinicians, supporting tailored interventions.

Analogy:

• BASE = video of where the patient is going
   
• MVMT = snapshot of where the patient has been
   
• Together → a geometric, actionable map of behavioral fragility
   

MVMT™ is the intellectual property of Philip Morisky and is exclusively distributed through Adherence Cartography. Unauthorized use, reproduction, or distribution is strictly prohibited.