Medication adherence is a key factor in the successful treatment of psychiatric and chronic health conditions. The Brief Adherence Rating Scale (BARS) is a clinician administered tool used to estimate how consistently a patient has taken their prescribed antipsychotic medication over the previous month. It offers a structured approach for understanding medication taking behavior and helps clinicians recognize when additional support or follow up may be needed.
This resource page outlines how the BARS works, why it is used in clinical practice, and what information it provides about adherence patterns. The BARS includes three structured questions and a visual analog scale that assist clinicians in estimating the proportion of doses taken.
A downloadable PDF of the Brief Adherence Rating Scale (BARS) is available for clinicians using the download resource button above.
Understanding How the BARS Works
The BARS includes three clinician administered questions that focus on the patient’s prescribed daily dose, the number of days medication was not taken, and the number of days the patient took less than the prescribed amount. The rating categories allow clinicians to record estimates such as few missed doses, moderate missed doses, or most missed doses. The PDF also includes a horizontal visual scale ranging from 0 percent to 100 percent that allows the clinician to mark the proportion of doses the patient reportedly took over the past month.
“Structured adherence assessments help clinicians identify when medication routines may be inconsistent and guide appropriate follow up.”
— National Institute of Mental Health
This perspective highlights the importance of using a simple and reliable tool to assess adherence, especially for individuals taking antipsychotic medications. While the BARS does not measure adherence with objective methods, it provides a clinically meaningful estimate that guides treatment planning, psychoeducation, and monitoring. Additional instructions and scoring information may be found in the downloadable resource using the download resource button above.
Frequently Asked Questions
Adults may miss medications due to forgetfulness, side effects, concerns about treatment, or difficulty maintaining routines. Life stressors and limited insight into illness can also influence adherence. Identifying these factors helps clinicians tailor interventions to support consistent medication use.
Consistent medication use supports symptom stability, reduces relapse risk, and improves long term outcomes. When doses are missed or taken inconsistently, symptoms may return or worsen. Understanding adherence patterns allows clinicians to intervene early and adjust treatment as needed.
Early signs may include missed appointments, inconsistent symptom control, or reports of lost or unused medication. Changes in mood, thinking, or behavior can also suggest inconsistent dosing. Recognizing these indicators supports timely conversations that help address barriers to adherence.
Strategies may include medication simplification, psychoeducation, behavioral supports, and the use of reminders or organizational tools. Medication classes with longer dosing intervals may be helpful when daily routines are difficult to maintain. A collaborative approach encourages patients to participate actively in treatment planning.
Alcohol and substance use may interfere with routines, reduce insight into treatment needs, or worsen side effects. These factors can lead to inconsistent medication taking and increased clinical risk. Assessing substance use as part of routine care helps clinicians develop integrated treatment plans.
Conclusion
The Brief Adherence Rating Scale is a practical and efficient tool for estimating how consistently patients take antipsychotic medication. Its three questions and adherence scale offer a quick and meaningful way to identify patterns that may require further support or intervention. Using the BARS helps clinicians initiate conversations that address challenges and promotes shared decision making.
Incorporating the BARS into regular clinical practice allows clinicians to recognize when additional support may be needed to maintain treatment effectiveness. The downloadable resource includes the complete scale and scoring guide using the download resource button above. The Brief Adherence Rating Scale is an important resource for understanding adherence patterns and guiding comprehensive care.
The Brief Adherence Rating Scale supports clinicians in assessing medication routines and identifying opportunities to enhance treatment outcomes.