OBJECTIVES: Treatment satisfaction with medication (TSM), a patient reported outcome, is an important factor in promoting patient adherence to prescription regimens. This review evaluates published instruments measuring TSM across various disease states. METHODS: A systematic literature review of Medline from 1980-2004 was conducted. Instruments measuring satisfaction with important attributes of treatment, as opposed to one-item global measures of satisfaction, were selected for review. The following fields were abstracted from articles for each instrument and summarized: applicable disease state; mode of administration; modules, domains and items; response options; method used for item development/selection; psychometric properties; and practicality. Standard psychometric measures including internal consistency and test-retest reliability, validity and responsiveness were chosen as evaluative criteria. Alpha ≥ 0.7 was chosen as acceptable for reliability. RESULTS: Eleven disease-specific instruments were identified (SATQ, PSAM, MTSM, DTSQ, PPMQ, PSIT, EDITS, PSQ, TSS-IOP, ITSQ, HIVTSQ), in addition to one generic instrument (TSQM). All these instruments are self-administered but vary widely in items, domains, and psychometric measures. The number of items range from eight (DTSQ) – 26 (SATQ) and the number of domains one - eight. All instruments except PSQ and EDITS were developed through patient reports. All measured internal consistency. Of the 12 instruments evaluated, only 6 measured test-retest reliability; 3 of the 6 (ITSQ, SATQ, and PSIT) had domains with low reproducibility (alpha <0.7). Only PPMQ reported responsiveness. Only MTSM measured patient expectations at baseline, and expectations, weighted by subjective importance of symptoms and the actual treatment experience, were used to derive TSM. CONCLUSIONS: This review determined that most TSM instruments have acceptable psychometric properties. However, expectations with treatment and clinical interpretation of change scores are missing from these measures. Further research is required to develop well-supported conceptual models of TSM, TSM measures in different therapeutic areas, and validation of existing measures in different populations.