School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia.
School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
Res Social Adm Pharm. 2022 Sep;18(9):3596-3601. doi: 10.1016/j.sapharm.2022.03.002. Epub 2022 Mar 8.
Understanding the perspective of health care professionals (HCPs) is significant to the implementation of deprescribing in older adults with limited life expectancy (LLE) but a tool to assess this is lacking.
This study aimed to develop and validate a survey tool for assessing HCPs attitudes towards deprescribing (HATD) in older adults with LLE.
An online survey was used to collect data to determine the psychometric properties of a 49-item questionnaire generated from literature review, expert opinion and pretesting. 108 HCPs (doctors, nurses and pharmacists) with experience or interest in palliative care or a member of a palliative care team/organisation completed the survey.
Principal component analysis of the participants' data resulted in a 23-item questionnaire structured in five factors, named HATD tool. The factors were related to concerns about deprescribing (7 items), perceived burden of medications on patients (7 items), organisational support for deprescribing (4 items), assurance to deprescribing (2 items) and perceived involvement of patients in medication management (3 items). The HATD tool had valid descriptive statistics (Kaiser-Meyer-Olkin measure: 0.708; Bartlett's test of sphericity: p < 0.001, determinant: 1.35E-5; variance explained: 60.4%; nonredundant residuals with absolute values > 0.05: 39%). The reliability statistics of all the factors were ≥0.750 for both Cronbach's alpha (α) and composite reliability (CR) except for the patient-involvement factor (α = 0.644 but CR = 0.787).
The 23-itemed HATD tool is a valid and reliable tool to assess the attitudes and beliefs of HCPs towards deprescribing in older adults with LLE in the Australian setting.
了解医疗保健专业人员（HCPs）的观点对于在预期寿命有限（LLE）的老年患者中实施减药至关重要，但缺乏评估工具。
本研究旨在开发和验证一种评估 HCPs 对 LLE 老年患者减药态度的调查工具（HATD）。
使用在线调查收集数据，以确定从文献综述、专家意见和预测试中生成的 49 项问卷的心理测量特性。108 名具有姑息治疗经验或兴趣或姑息治疗团队/组织成员的 HCPs 完成了调查。
对参与者数据的主成分分析得出了一个 23 项的问卷，分为五个因素，命名为 HATD 工具。这些因素与对减药的担忧（7 项）、患者药物负担的感知（7 项）、组织对减药的支持（4 项）、对减药的保证（2 项）和患者对药物管理的参与度（3 项）有关。HATD 工具具有有效的描述性统计（Kaiser-Meyer-Olkin 度量值：0.708；Bartlett 球形检验：p<0.001，行列式：1.35E-5；解释方差：60.4%；绝对值>0.05 的非冗余残差：39%）。除患者参与因素（α=0.644，但 CR=0.787）外，所有因素的可靠性统计数据均≥0.750，包括 Cronbach's alpha（α）和综合可靠性（CR）。
在澳大利亚，23 项的 HATD 工具是一种有效的、可靠的工具，可以评估 HCPs 对 LLE 老年患者减药的态度和信念。
