Clinical Pharmacy research group, Louvain Drug Research Institute, Université catholique de Louvain, Avenue Emmanuel Mounier 72, 1200, Brussels, Belgium.
Clinical Pharmacy research group, Louvain Drug Research Institute, Université catholique de Louvain, Avenue Emmanuel Mounier 72, 1200, Brussels, Belgium; Pharmacy Department, Université Catholique de Louvain, CHU UCL Namur, Rue Dr Gaston Therasse 1, 5530, Yvoir, Belgium.
Res Social Adm Pharm. 2023 Sep;19(9):1278-1285. doi: 10.1016/j.sapharm.2023.05.010. Epub 2023 Jun 8.
The revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire explores older adults' views on deprescribing in general. Those views may differ, however, when the target is a specific drug such as benzodiazepine receptor agonists (BZRA).
This study aimed to adapt the 22-item French rPATD questionnaire to create a BZRA-specific instrument and to assess the psychometric properties of this new tool.
The adaptation of the questionnaire comprised 3 steps: 1) item transformation during group discussions with 8 healthcare providers and 8 BZRA users (aged ≥65 years), 2) pre-test of the questionnaire with 12 other older adults to ensure items understanding, 3) evaluation of the psychometric properties of the new questionnaire with 221 older BZRA users recruited in Belgium, France, and Switzerland. Construct validity was assessed using exploratory factor analysis (EFA), internal consistency with Cronbach's alpha, and test-retest reliability with intraclass correlation coefficient (ICC).
After the pre-test, the questionnaire had 24 items (19 adapted from the French rPATD, 3 removed, and 5 added). The EFA, however, found that several items performed poorly. Eleven items were consequently removed, based on statistical performance and clinical relevance. Three factors were extracted from the EFA performed on the 11 retained items and were named "Concerns about stopping BZRA", "BZRA inappropriateness", and "Dependence on BZRA". The questionnaire also includes two global questions about willingness to reduce BZRA dosage and willingness to discontinue BZRA. All factors showed acceptable internal consistency (0.68 ≤ Cronbach's alpha ≤0.74). Two factors showed acceptable test-retest reliability. The "Concerns about stopping BZRA" factor was found to vary over time (ICC [95%CI]: 0.35[-0.02; 0.64]).
We developed and validated a 13-item questionnaire to evaluate the attitudes of older people towards BZRA deprescribing. Despite some limitations, this questionnaire appears to be a useful tool for facilitating shared decision-making on BZRA deprescribing.
修订后的患者对减药态度问卷（rPATD）探讨了老年人对一般减药的看法。然而，当目标是特定药物（如苯二氮䓬受体激动剂（BZRA））时，这些看法可能会有所不同。
本研究旨在改编 22 项法语 rPATD 问卷，创建一个专门针对 BZRA 的工具，并评估该新工具的心理测量特性。
问卷改编包括 3 个步骤：1）与 8 名医疗保健提供者和 8 名 BZRA 用户（年龄≥65 岁）进行小组讨论，进行项目转换；2）对 12 名其他老年人进行预测试，以确保理解项目；3）在比利时、法国和瑞士招募了 221 名老年 BZRA 用户，评估新问卷的心理测量特性。使用探索性因子分析（EFA）评估结构效度，使用 Cronbach's alpha 评估内部一致性，使用组内相关系数（ICC）评估测试-重测信度。
预测试后，问卷有 24 个项目（19 个改编自法语 rPATD，3 个删除，5 个添加）。然而，EFA 发现，一些项目表现不佳。根据统计性能和临床相关性，随后删除了 11 个项目。从保留的 11 个项目的 EFA 中提取了 3 个因子，并分别命名为“停止 BZRA 的担忧”、“BZRA 不适当”和“对 BZRA 的依赖”。问卷还包括两个关于减少 BZRA 剂量意愿和停止 BZRA 意愿的总体问题。所有因子的内部一致性均较高（0.68≤Cronbach's alpha≤0.74）。两个因子的测试-重测信度均较高。“停止 BZRA 的担忧”因子随时间变化（ICC[95%CI]：0.35[-0.02; 0.64]）。
我们开发并验证了一个 13 项问卷，用于评估老年人对 BZRA 减药的态度。尽管存在一些限制，但该问卷似乎是促进 BZRA 减药共同决策的有用工具。
