Carina Lundby1, Trine Simonsen2, Jesper Ryg3, Jens Søndergaard4, Anton Pottegård5, Henrik Hein Lauridsen6. 1. Hospital Pharmacy Funen, Odense University Hospital, Odense C, Denmark; OPEN, Open Patient Data Explorative Network, Odense University Hospital, Odense C, Denmark; Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark. Electronic address: carina.lundby.olesen@rsyd.dk. 2. Hospital Pharmacy Funen, Odense University Hospital, Odense C, Denmark. 3. Department of Geriatric Medicine, Odense University Hospital, Odense C, Denmark; Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark. 4. Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark. 5. Hospital Pharmacy Funen, Odense University Hospital, Odense C, Denmark; Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense C, Denmark. 6. Research Unit of Clinical Biomechanics, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.
Abstract
BACKGROUND: Knowledge about patients' attitudes towards deprescribing is essential for optimizing medication use. The revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire is a 22-item self-report instrument capturing older patients' beliefs and attitudes towards deprescribing. OBJECTIVES: To translate and cross-culturally adapt the rPATD questionnaire into Danish and subsequently validate it in a cohort of nursing home residents. METHODS: The rPATD questionnaire was translated and cross-culturally adapted during five stages of forward and backward translation. The validation study included 162 Danish nursing home residents (median age 84 years; 67% women). Validity was assessed through exploratory factor analysis (structural validity) and hypothesis testing (construct validity), while reliability was assessed through internal consistency. Floor and ceiling effects were examined. RESULTS: The exploratory factor analysis revealed a 4-factor structure similar to the original rPATD questionnaire, with items loading into four factors related to level of involvement in medication use, perceived burden of taking medication, belief in appropriateness of using medication, and concerns about stopping medication. The questionnaire was adjusted to the Danish nursing home population and health care system by omission of two items, concerning medication expenses and inconvenience of taking medication, which resulted in a model with factor loadings ranging from 0.29 to 0.84 and only minor cross-loading. Construct validity correctly predicted 67% of the hypothesized correlations. Internal consistency of all factors was generally acceptable with Cronbach's α ranging from 0.67 to 0.78. No floor and ceiling effects were identified. CONCLUSIONS: Results suggest that the Danish modified model of the rPATD questionnaire generally has acceptable validity and reliability.
BACKGROUND: Knowledge about patients' attitudes towards deprescribing is essential for optimizing medication use. The revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire is a 22-item self-report instrument capturing older patients' beliefs and attitudes towards deprescribing. OBJECTIVES: To translate and cross-culturally adapt the rPATD questionnaire into Danish and subsequently validate it in a cohort of nursing home residents. METHODS: The rPATD questionnaire was translated and cross-culturally adapted during five stages of forward and backward translation. The validation study included 162 Danish nursing home residents (median age 84 years; 67% women). Validity was assessed through exploratory factor analysis (structural validity) and hypothesis testing (construct validity), while reliability was assessed through internal consistency. Floor and ceiling effects were examined. RESULTS: The exploratory factor analysis revealed a 4-factor structure similar to the original rPATD questionnaire, with items loading into four factors related to level of involvement in medication use, perceived burden of taking medication, belief in appropriateness of using medication, and concerns about stopping medication. The questionnaire was adjusted to the Danish nursing home population and health care system by omission of two items, concerning medication expenses and inconvenience of taking medication, which resulted in a model with factor loadings ranging from 0.29 to 0.84 and only minor cross-loading. Construct validity correctly predicted 67% of the hypothesized correlations. Internal consistency of all factors was generally acceptable with Cronbach's α ranging from 0.67 to 0.78. No floor and ceiling effects were identified. CONCLUSIONS: Results suggest that the Danish modified model of the rPATD questionnaire generally has acceptable validity and reliability.
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