Translation and psychometric properties of the Arabic version of the revised Patients' Attitudes Towards Deprescribing questionnaire

Abstract

Objectives This study aims to validate an Arabic version of the revised Patients' Attitudes Toward Deprescribing (rPATD) translated tool and to describe polypharmacy patients' attitudes toward deprescribing in Jordan. Methods rPATD translation was guided by ISPOR's Principles of Good Practice. A convenient sample of adult outpatients with polypharmacy was recruited from a major teaching hospital in Jordan. Reliability was assessed using Cronbach's alpha and the intraclass correlation coefficient (ICC). Validity was assessed using face and construct validity using confirmatory factor analysis. Key findings A total of 358 questionnaires were collected from patients (mean age: 60.4 AE 12.03). Overall, polypharmacy patients were willing to stop one or more of their medications upon a physician's recommendations and were not concerned about deprescribing. Similar to the original rPATD tool, factor analysis resulted in four factors (burden, appropriateness, concern about stopping, and involvement). Internal consistencies for constructs ranged from 0.718 (appropriateness) to 0.85 (concerns about stopping). ICC ranged from 0.718-0.972, indicating good to excellent reliability. Conclusions This study provided an Arabic translation of the rPATD with evidence of validity and reliability comparable to the original tool. The Arabic rPATD could be used for adult patients in Arabic-speaking countries to ultimately contribute to the global literature of deprescribing. Overall, the patients in this study showed a favourable attitude towards deprescribing through a shared decision-making process with their physicians. This can be seen as an opportunity to reduce the burden of polypharmacy and unnecessary medications.

Exploring Patients’ Attitudes Toward Deprescribing and Their Perception of Pharmacist Involvement in a European Country: A Cross-Sectional Study

“…Nevertheless, opinions of older participants from this study are comparable to opinions of older adults worldwide. 26 , 29 , 30 , 36 , 41–46 While younger participants might not have expressed their willingness to have medication deprescribed through the global question, they were more likely to have lower appropriateness factor score. Low appropriateness factor score was found to be a predictive factor for willingness to have medication discontinued and could indicate younger participants require additional attention and conversation regarding their pharmacotherapy.…”

Potentially inappropriate medication and attitudes of older adults towards deprescribing

“…The Beers 2019 version is updated according to the latest evidence and includes drug-drug interactions when assessing PIMs. Lastly, we used the rPATD questionnaire, which is validated and has been used internationally to assess willingness to deprescribe [ 37 , 54 ]. We followed international standards with independent forward and back translation to translate the rPATD into German.…”

Cross-cultural adaptation and psychometric validation of a Spanish version of the revised Patients’ Attitudes Towards Deprescribing (rPATD) questionnaire

“…Using an in-person questionnaire exclusively in subjects from the primary care setting was prioritised over both in-person and online administration of the original validation study, which may have increased this questionnaire’s external validity. In the same way, although the target population in the original validation study was older adults (>65 years of age), we did not establish any age limit, similarly to the validation of the Arabic version of the questionnaire,27 in order to generalise its use to patients with polypharmacy and not only older adults. Despite this, the four-factor structure of the original rPATD questionnaire was maintained.…”

“…The rPATD questionnaire was originally developed in English. It has been translated into other languages, including Dutch,24 Amharic25 and Malay,26 although it has only been formally validated into Arabic,27 Danish28 and French 29. To date, it has not been validated into Spanish.…”