Drug Attitude Inventory (DAI)
Also known as: DAI, DAI-10, DAI-30
The Drug Attitude Inventory (DAI) is a brief self-report measure developed by Hogan, Awad, and Eastwood in 1983 to assess attitudes toward medication and predicted medication compliance in schizophrenia and other psychiatric conditions. The original 30-item version (DAI-30) and the widely used 10-item short form (DAI-10) capture patients' subjective experience of medication benefit, side effects, and overall willingness to take medication as a predictor of adherence. The DAI is particularly valuable in psychiatric care, where attitudes toward antipsychotic and antidepressant medications strongly predict adherence and clinical outcomes.
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When to use it
The DAI is most appropriate for patients with schizophrenia, bipolar disorder, depression, or other psychiatric conditions on antipsychotic, mood stabilizer, or antidepressant medications. It is valuable at baseline to predict risk of non-adherence, during follow-up to monitor attitude shifts that may signal adherence problems, and after medication changes to assess whether new regimens are better tolerated. The DAI is less commonly used in non-psychiatric populations, though it can be adapted for any chronic medication context. It is particularly useful when insight varies (as in schizophrenia spectrum disorders) because it measures subjective attitude rather than objective understanding of illness.
Strengths & limitations
- Strong predictive validity for psychiatric medication adherence: DAI score at baseline predicts actual medication adherence and clinical outcomes (relapse, hospitalization) in schizophrenia and related conditions.
- Brief and practical: DAI-10 is only 10 items; completed in 5 minutes; very acceptable to patients.
- Captures subjective experience: Measures how the patient actually experiences medication (benefit, side effects, quality of life), not just clinical indication—critical for psychiatric care.
- Sensitive to change: DAI scores change with medication adjustment, dose modification, or side effect management, making it useful for monitoring intervention efficacy.
- Cross-cultural validity: Validated in multiple languages and across diverse psychiatric populations.
- Self-report bias: Vulnerable to social desirability; patients may overstate positive attitudes to please clinicians, especially in coercive psychiatric settings.
- Lack of specificity about reasons: Measures global attitude but does not detail specific side effects, concerns, or barriers; requires follow-up questions.
- Limited in non-psychiatric contexts: Most validation is in schizophrenia and bipolar disorder; less data in other conditions.
- Insight-dependent: In patients with very poor illness insight, low DAI scores may reflect lack of insight rather than rational assessment of medication utility.
- Does not measure adherence directly: Measures attitude, which predicts but does not determine adherence; other barriers (cost, access, forgetfulness) may intervene.
Frequently asked
A patient scores -4 on the DAI-10. Does this mean they will definitely not adhere?
Not necessarily. A DAI-10 score of -4 indicates negative attitudes toward medication and is associated with increased non-adherence risk, but it does not guarantee non-adherence. Some patients with negative attitudes still adhere due to family pressure, structured supervision, legal mandate, or practical support. However, a low DAI score is a red flag warranting intervention. Explore reasons: 'I see that you have concerns about your medication. What specifically bothers you about it?' Then address root causes (side effects, perceived lack of benefit, stigma, or misunderstanding).
Should I use DAI-30 or DAI-10?
DAI-10 is preferred in most clinical settings due to its brevity (5 minutes vs. 15 minutes for DAI-30). The short form has similar predictive validity for adherence as the longer version. Use DAI-10 unless you have a specific research need for greater detail or are conducting a study that has used DAI-30 in prior publications for comparability.
A patient's DAI score is positive (+3), but they just relapsed. What does this mean?
Positive DAI score indicates favorable attitudes toward medication and predicted good adherence, but this patient had a relapse—likely indicating either actual non-adherence despite favorable attitudes, or another cause (stress, substance use, medical illness). Investigate: (1) actual adherence (pharmacy refills, pill counts, serum levels), (2) recent medication changes, (3) psychosocial stressors, (4) substance use. A positive DAI without adherence suggests other barriers beyond attitudes (forgetfulness, access, side effects that developed recently). Combine DAI with adherence measures.
Can I use DAI with patients not on antipsychotics?
The DAI is most validated for antipsychotic and mood stabilizer medications. It can be adapted for other psychiatric medications (antidepressants) or even non-psychiatric medications, but with caution. Some items reference 'thinking clearly' or 'staying healthy,' which may not be equally relevant in all contexts. If using DAI in a population not explicitly validated in prior research, consider administering alongside other measures (MARS, BMQ) to ensure comprehensive assessment.
Sources
- Hogan, T. P., Awad, A. G., & Eastwood, R. (1983). A self-report scale predictive of drug compliance in schizophrenics: Reliability and discriminative validity. Psychological Medicine, 13(1), 177-183. DOI: 10.1017/s0033291700050182 ↗
How to cite this page
ScholarGate. (2026, June 3). Drug Attitude Inventory (DAI). ScholarGate. https://scholargate.app/en/pharmacology/drug-attitude-inventory
Which method?
Set this method beside its closest kin and read them side by side — the library lays the books on the table; the choice is yours.
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