Amy M Linsky1,2,3, Kelly Stolzmann4, Mark Meterko5,6. 1. Section of General Internal Medicine (152G), VA Boston Healthcare System, 150 S. Huntington Ave, Boston, MA, 02130, USA. amy.linsky@va.gov. 2. Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System and ENRM Veterans Affairs Medical Center, Boston/Bedford, MA, USA. amy.linsky@va.gov. 3. Section of General Internal Medicine, Boston Medical Center, Boston, MA, USA. amy.linsky@va.gov. 4. Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System and ENRM Veterans Affairs Medical Center, Boston/Bedford, MA, USA. 5. Patient Experience Survey Program, VHA Office of Reporting, Analytics, Performance, Improvement and Deployment, Bedford, MA, USA. 6. Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.
Abstract
INTRODUCTION: Deprescribing, the intentional reduction of medication, is recognized as an important component of clinical care; however, standardized identification of patient attitudes and beliefs that contribute to deprescribing may be limited due to the length of current surveys. We sought to develop a short-form (≤ 15 items) of the patient perceptions of deprescribing (PPoD) questionnaire, a validated 30-item instrument that assesses dimensions relevant to deprescribing, to be used in clinical and research settings. METHODS: We conducted a secondary analysis of data from 803 US veteran respondents to the original PPoD survey, randomly divided into derivation and validation samples. In the derivation sample, we used ordinary least squares linear regression with R2 model selection to identify candidate items reflective of overall readiness for deprescribing. We then used iterative multitrait analysis, followed by confirmatory factor analysis (CFA) in the validation sample to assess the psychometric properties of the proposed short form. RESULTS: The resulting short-form PPoD consisted of 11 items representing two overarching domains reflective of overall readiness for deprescribing: 'Motivation for Deprescribing' and 'Primary Care Provider Relationship'. CFA fit statistics supported the proposed structure and the two new scales demonstrated high internal consistency reliability (Cronbach alphas: 0.82 and 0.91, respectively) and good discriminant validity (interscale correlation - 0.30). DISCUSSION: The proposed short-form PPoD captures two important sources of variance in patient readiness for deprescribing: motivation and patients' relationships with their primary care providers. This brief, 11-item survey may help foster the inclusion of patient perceptions into clinical decision making for deprescribing to yield safer, more appropriate medication use.
INTRODUCTION: Deprescribing, the intentional reduction of medication, is recognized as an important component of clinical care; however, standardized identification of patient attitudes and beliefs that contribute to deprescribing may be limited due to the length of current surveys. We sought to develop a short-form (≤ 15 items) of the patient perceptions of deprescribing (PPoD) questionnaire, a validated 30-item instrument that assesses dimensions relevant to deprescribing, to be used in clinical and research settings. METHODS: We conducted a secondary analysis of data from 803 US veteran respondents to the original PPoD survey, randomly divided into derivation and validation samples. In the derivation sample, we used ordinary least squares linear regression with R2 model selection to identify candidate items reflective of overall readiness for deprescribing. We then used iterative multitrait analysis, followed by confirmatory factor analysis (CFA) in the validation sample to assess the psychometric properties of the proposed short form. RESULTS: The resulting short-form PPoD consisted of 11 items representing two overarching domains reflective of overall readiness for deprescribing: 'Motivation for Deprescribing' and 'Primary Care Provider Relationship'. CFA fit statistics supported the proposed structure and the two new scales demonstrated high internal consistency reliability (Cronbach alphas: 0.82 and 0.91, respectively) and good discriminant validity (interscale correlation - 0.30). DISCUSSION: The proposed short-form PPoD captures two important sources of variance in patient readiness for deprescribing: motivation and patients' relationships with their primary care providers. This brief, 11-item survey may help foster the inclusion of patient perceptions into clinical decision making for deprescribing to yield safer, more appropriate medication use.
Authors: Yee Lin Chock; Yuan Lin Wee; Su Lene Gan; Kah Woon Teoh; Khuen Yen Ng; Shaun Wen Huey Lee Journal: J Gen Intern Med Date: 2021-06-25 Impact factor: 5.128